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  •  Insulinoma: literature review and clinical case description

    Редактор | 2024, Literature reviews, Practical medicine part 22 №4. 2024 | 31 августа, 2024

    T.A. KISELEVA¹, D.R. ISLAMOVA¹, K.R. BAGAUTDINOVA²

     ¹Kazan State Medical University, Kazan

    ²City Polyclinic No. 18, Kazan

     Contact details:

    Kiseleva T.A. — PhD (Medicine), Associate Professor of the Department of Endocrinology

    Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-917-390-88-99, e— mail: tattiana@mail.ru

    Insulinoma is a neuroendocrine tumor arising from β-cells of the islets of Langerhans, causing hypoglycemic attacks due to endogenous hyperinsulinism. The worldwide prevalence is approximately 1 case per 250,000–1,000,000 population, the incidence is 1–4 cases per million population per year. In most cases, the formation of insulinoma is sporadic (90%), less often it can be detected as part of the multiple endocrine neoplasia syndrome type 1 (10%). This review discusses the pathogenetic mechanisms of hypoglycemic syndrome, criteria for differential diagnosis, modern laboratory and imaging methods, and approaches to the treatment of insulinoma. A clinical observation is presented that demonstrates the difficulties of timely diagnosis of insulinoma due to nonspecific manifestations of hypoglycemia. The time that elapses from the first manifestations of hypoglycemic syndrome to diagnosis directly affects the prognosis and quality of life of a patient with insulinoma. It requires vigilance from doctors of all specialties regarding the clinical features of this disease.

    Key words: insulinoma, hypoglycemic syndrome, neuroendocrine tumors, diagnosis, treatment.

    REFERENCES

    1. De Herder W.W., Zandee W.T., Hofland J. Insulinoma. In: Feingold K.R., Anawalt B., Blackman M.R. et al., eds. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc., 2020.
    2. Zhuo F., Anastasopoulou C. Insulinoma [cited 2022 Jul 24]. In: StatPearls, available at: https://www.ncbi.nlm.nih.gov/books/NBK544299
    3. Khatsimova L.S., Karonova T.L., Tsoy U.A. et al. Insulinoma: diagnostic approaches and medical practice. Problemy endokrinologii, 2017, vol. 63, no. 4, pp. 212–218 (in Russ.). DOI: 10.14341/probl2017634212-218
    4. Krivko A.A., Mel’nichenko G.A., Kuznetsov N.S. et al. Modern technologies in diagnostics and treatment of insulinoma. Problemy endokrinologii, 2013, vol. 59, no. 5, pp. 36–41 (in Russ.). DOI: 10.14341/probl201359536-41
    5. Mcauley G., Delaney H., Colville J., et al. Multimodality preoperative imaging of pancreatic insulinomas. Clin. Radiol, 2005, vol. 60 (10), pp. 1039–1050. DOI: 10.1016/j.crad.2005.06.005
    6. Yukina M.Yu., Nuralieva N.F., Troshina E.A. et al. Hypoglycemic syndrome (insulinoma): pathogenesis, etiology, laboratory diagnostics. Literature review (part 1). Problemy Endokrinologii, 2017, vol. 63, no. 4, pp. 245–256 (in Russ.). DOI: 10.14341/probl2017634245-256
    7. Shevchenko Yu.L., Karpov O.E., Stoyko Yu.M. et al. Modern diagnostics and surgical tactics for pancreatic insulinomas. Vestnik Natsional’nogo mediko-khirurgicheskogo Tsentra im. N. I. Pirogova, 2016, vol. 11, no. 1, pp. 6–9 (in Russ.).
    8. Guerci B., Kuhn J-M, Larger E. et al. Hypoglycaemia in adults: when should it be raised? How can hypoglycaemia be confirmed in non-diabetic adults? Ann. Endocrinol. (Paris), 2013, vol. 74 (3), pp. 168–173. DOI: 10.1016/j.ando.2013.05.002
    9. Cryer P. Glucose homeostasis and hypoglycemia In: Kronenberg H, Melmed S, Polonsky K. et al., eds. Williams textbook of endocrinology, 11th ed. Philadelphia: Saunders, an imprint of Elsevier, Inc.; 2008. Rr.1503–1533.
    10. Yukina M.Yu., Nuralieva N.F., Troshina E.A. et al. Hypoglycemic syndrome (insulinoma): topical, pathomorphological and genetic diagnostics, treatment. Literature review (part 2). Problemy endokrinologii, 2017, vol. 63, no. 5, pp. 346–355 (in Russ.). DOI: 10.14341/probl2017635346-355
    11. Lin X.Z., Wu Z.Y., Tao R. et al. Dual energy spectral CT imaging of insulinoma-Value in preoperative diagnosis compared with conventional multi-detector CT. Eur. J. Radiol, 2012, vol. 81 (10), pp. 2487–2494. DOI: 10.1016/j.ejrad.2011.10.028

    Метки: 2024, D.R. ISLAMOVA, diagnosis, hypoglycemic syndrome, insulinoma, K.R. BAGAUTDINOVA, neuroendocrine tumors, Practical medicine part 22 №4. 2024, T.A. KISELEVA, treatment

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