Insulinoma-current diagnosis and surgical management

Edis, Anthony J.; McIlrath, Donald C.; Heerden, Jonathan A. van; Fulton, Richard E.; Sheedy, Patrick F.; Service, F. John; Dale, Allan J. D.

doi:10.1016/s0011-3840(76)80010-x

Cited by 52 publications

(19 citation statements)

References 29 publications

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“…In this series anti-insulin scanning correctly localized four of eight subsequently proven insulinomata. This compares with 90% accurately localized by pancreatic angiography in the best hands (Edis et al, 1976) and 80% in the best report using CT scanning with i.v. contrast enhancement (Rossi et al, 1985) but this group contained many large tumours.…”

Section: Discussionmentioning

confidence: 67%

An Evaluation of Anti‐insulin Radioimmunodetection in Patients With Suspected Insulinoma

Chapman

Fairweather

Keeling

et al. 1987

Clinical Endocrinology

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Nine patients with suspected insulinoma were scanned with iodine-131 labelled anti-insulin. The clinical diagnosis was subsequently confirmed at laparotomy in eight patients, two of whom had liver metastases. The primary insulinoma was accurately localized by anti-insulin scanning in four patients and these tumours ranged from 1 to 3 cm in diameter. Both computerized axial tomography (CT) scanning and pancreatic angiography had given false negative results in one of these patients. Hepatic metastases were correctly identified in one of two patients. No hepatic false positive reports occurred. Positive scan areas were graded as definite, probable or possible. All four of the pancreatic positive results graded as definite or probable positive were correct. Three false positive results occurred in the region of the pancreatic body, all had been graded as possible. Anti-insulin scanning failed to detect four subsequently proven insulinomata (3 mm-2 cm in diameter). Pelvic uptake of anti-insulin occurred in a patient who was found to have a para-ovarian tumour. An homogenate of this tumour also reacted with anti-insulin in a radioimmunoassay. A true negative pancreatic scan was obtained in this patient. We conclude that this technique is insufficiently accurate for routine clinical use.

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Section: Discussionmentioning

confidence: 67%

An Evaluation of Anti‐insulin Radioimmunodetection in Patients With Suspected Insulinoma

Chapman

Fairweather

Keeling

et al. 1987

Clinical Endocrinology

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“…In fact the one patient with insulinoma discovered after gastric banding gained weight despite 4 band-tightening procedures [19]. These patterns are reminiscent of the weight gain often observed in patients with sporadic insulinoma [20], attributed to both the anabolic effects of insulin and the need for increased food intake to treat hypoglycemia. Weight regain is common in the post-bariatric patient [21], potentially in relation to gut mucosal hypertrophy and GLP2 secretion [22, 23] and is thus not specific for excessive insulin secretion.…”

Section: Resultsmentioning

confidence: 99%

Insulinoma After Bariatric Surgery: Diagnostic Dilemma and Therapeutic Approaches

et al. 2016

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Hypoglycemia is increasingly recognized as a complication of bariatric surgery. Typically hypoglycemia does not appear immediately postoperatively, but rather more than 1 year later, and usually occurs 1–3 hours after meals. While rare, insulinoma has been reported after bariatric surgery. Clinical factors which should raise suspicion for insulinoma and the need for comprehensive clinical and biochemical evaluation include hypoglycemia occurring in the fasting state, predating bariatric surgery and/or worsening immediately postoperatively, and lack of response to conservative therapy. Localization and successful resection of insulinoma can be achieved using novel endoscopic ultrasound and surgical approaches. In summary, hypoglycemia presenting shortly after gastric bypass or with a dominant fasting pattern should be fully evaluated to exclude insulinoma. Additionally, evaluation prior to gastric bypass should include screening for history of hypoglycemia symptoms.

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“…Of these tumours, 90% are iNot to be confused with 'paracrine', which refers to the secretion of a substance which normally has only a local action. single and benign and are cured by one operation (Edis et al, 1976).…”

Section: The Insulinomamentioning

confidence: 99%

“…Selective arteriography (Fig. 3) is particularly helpful for pancreatic tumours (Edis et al, 1976). Selective venous sampling may be helpful (Fig.…”

Section: The Carcinoid Tumourmentioning

confidence: 99%

Clinical features and diagnosis of alimentary endocrine tumours.

Welbourn¹

1978

Journal of Clinical Pathology

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Insulinoma-current diagnosis and surgical management

Cited by 52 publications

References 29 publications

An Evaluation of Anti‐insulin Radioimmunodetection in Patients With Suspected Insulinoma

An Evaluation of Anti‐insulin Radioimmunodetection in Patients With Suspected Insulinoma

Insulinoma After Bariatric Surgery: Diagnostic Dilemma and Therapeutic Approaches

Clinical features and diagnosis of alimentary endocrine tumours.

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