title: Giant pancreatic insulinoma. The bigger the worse? Report of two cases and literature review.
abstract: BACKGROUND
  Giant pancreatic insulinomas are rare endocrine tumors. We describe 2 cases reviewing the current literature.
  
  
  METHODS
  We report herein 2 female patients affected by giant insulinomas of 14cm and 6cm, respectively. Symptomatic hypoglycemia episodes occurred during 4 months in first case and 3 years in the second one until diagnosis. Both patients were successfully treated performing a distal pancreatectomy with splenic preservation in the first case and a Whipple's procedure in the second one.
  
  
  CONCLUSIONS
  Up to now only 7 cases have been reported previously. Insulinomas larger than 3cm accounts for less than 5% of all. This literature review shows that despite the size hypoglycemic symptoms varies from 1 day to 3 years and only 1 out of 9 cases reported presented lymph nodes metastases. No recurrences have been described.
  
  
  CONCLUSIONS
  One of the cases here described (14cm) is the largest presented in the literature. Despite the size, giant insulinoma is related apparently neither to metastases nor to the recurrences.
authors: Madrid Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain. Electronic address: ielpo.b@gmail.com.
authors: Benedetto
authors: B
authors: Ielpo
authors: Riccardo
authors: R
authors: Caruso
authors: Valentina
authors: V
authors: Ferri
authors: Yolanda
authors: Y
authors: Quijano
authors: Hipolito
authors: H
authors: Duran
authors: Eduardo
authors: E
authors: Diaz
authors: Isabel
authors: I
authors: Fabra
authors: Ramon
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authors: Puga
authors: Catalina
authors: C
authors: Oliva
authors: Sergio
authors: S
authors: Olivares
authors: Emilio
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authors: Vicente