Review of eight cases of insulinoma.
OBJECTIVE
To review patients records operated with the diagnosis of insulinoma and to discuss their clinical presentations, diagnostic and therapeutic modalities.


METHODS
Retrospective study.


METHODS
Ankara Numune Teaching and Research Hospital, Turkey.


METHODS
Eight cases were operated in the Department of 6th Surgery, Ankara Numune Teaching and Research Hospital between 1994 and 2000. All patients had neuroglycopenic symptoms. Six patients had blood glucose levels of lower than 50 mg/dL during the admission. The other two patients had hypoglycaemia in the prolonged fasting test. Serum insulin/glucose ratio was diagnostic in all patients except one. Abdominal ultrasonography and computerised tomography could successfully localise the tumour in one case. In six patients tumours could be localised by endoscopic pancreatic ultrasonography. In one patient none of the studies could localise the tumour. Three tumours were located at the pancreatic head, one in the neck, two at the body and two at the tail. All tumours except one were palpable. Enucleation was the procedure of choice in four cases and distal pancreatectomy was the procedure of choice in four.


RESULTS
Post-operative course was uneventful in seven patients. One patient died due to intra-abdominal sepsis. Hypoglycaemia was controlled in all patients after the surgery.


CONCLUSIONS
Surgery is the mainstay of treatment of insulinoma. Enucleation should be the procedure of choice if possible. Endoscopic pancreatic ultrasonography has promising results and may replace invasive angiographic studies in the future.
Besim
H
H
Endocrinology Unit, Ankara Numune Teaching and Research Hospital, Turkey.
Korkmaz
A
A
Hamamcy
O
O
Karaahmetoglu
S
S
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D003221:Confusion / Q000209:etiology; D003937:Diagnosis, Differential; D004244:Dizziness / Q000209:etiology; D019160:Endosonography; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000209:etiology; D007328:Insulin / Q000097:blood; D007340:Insulinoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014421:Turkey; D014474:Unconsciousness / Q000209:etiology
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin