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Clinical Management of Malignant Insulinoma: a single Institution's experience over three decades.
- Source :
- BMC Endocrine Disorders; 12/6/2018, Vol. 18 Issue 1, pN.PAG-N.PAG, 1p, 3 Charts
- Publication Year :
- 2018
-
Abstract
- Background: Malignant insulinoma is extremely rare and accounts for only 10% of total insulinoma cases. The goal of this study is to retrospectively analyze clinical data from 15 patients with malignant insulinoma treated at Peking Union Medical College Hospital (PUMCH) from 1984 to April 2017. Methods: "Malignant insulinoma" was used as the keywords in the PUMCH medical record retrieval system to search and obtain patients' clinical information. We identified subjects diagnosed with malignant insulinoma based on clinical or surgical pathological signs and subsequently analyzed their clinical data. Results: Eight males and seven females with a median age at diagnosis of 40 years (38–54 years) were included. Eight patients (53%) had developed metastases at diagnosis, while the others (46.67%) developed metastases during the follow-up visits. The major sites of metastasis were the liver (86.7%), local tissues and blood vessels (33%) and abdominal lymph nodes (13%). All patients displayed neuroglycopenic (100%) and/or autonomic (60%) symptoms, mostly during fasting periods (73.3%), with an average blood glucose level of 1.66 ± 0.51 mmol/L. A total of 93% of the patients had one primary pancreatic lesion, 53% had a lesion in the head of the pancreas, and 47% had a lesion in the tail of the pancreas, with diameters ranging between 0.9 and 6.0 cm. Most liver metastases were multiple lesions. Selective celiac arteriography yielded 100% sensitivity for both primary pancreatic lesions and liver metastases. Most patients received synthetical treatments, including surgery, chemoembolization, and octreotide. Conclusions: Malignant insulinomas have a similar diagnostic process to that of benign insulinomas but require far more comprehensive therapies to alleviate hypoglycemic symptoms and extend patients' survival. [ABSTRACT FROM AUTHOR]
- Subjects :
- OCTREOTIDE acetate
ACADEMIC medical centers
ANGIOGRAPHY
AUTONOMIC nervous system diseases
BLOOD sugar
BLOOD-vessel tumors
CELIAC artery
FASTING
LIVER tumors
ISLANDS of Langerhans tumors
LYMPH nodes
MEDICAL appointments
METASTASIS
SURVIVAL
RETROSPECTIVE studies
CHEMOEMBOLIZATION
SYMPTOMS
DIAGNOSIS
TUMOR treatment
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 14726823
- Volume :
- 18
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Endocrine Disorders
- Publication Type :
- Academic Journal
- Accession number :
- 133437603
- Full Text :
- https://doi.org/10.1186/s12902-018-0321-8