Metastatic insulinoma


Metastatic insulinoma: A rare form of pancreatic cancer that causes excessive secretion of the hormone insulin and can spread to other parts of the body (metastasis).


The list of signs and symptoms mentioned in various sources for Metastatic insulinoma includes the 10 symptoms listed below: Fasting hypoglycemia - excess insulin CNS symptoms - excess insulin Ataxia - excess insulin Confusion - excess insulin Weakness - excess insulin Headache - excess insulin Vision problems - excess insulin Personality changes - excess insulin Seizures - excess insulin Paralysis Note that Metastatic insulinoma symptoms usually refers to various symptoms known to a patient, but the phrase Metastatic insulinoma signs may refer to those signs only noticable by a doctor.


The genetic changes in neuroendocrine tumors are under investigation.3 The gene of MEN, an autosomal dominant disease, is called MEN1 and maps to band 11q13. MEN1 is thought to function as a tumor suppressor gene. New data suggest that the MEN1 gene also is involved in the pathogenesis of at least one third of sporadic neuroendocrine tumors. Researchers were able to detect loss of heterozygosity in band 11q13 in DNA samples from resected insulinoma tissue by using fluorescent microsatellite analysis.


Home medical testing related to Metastatic insulinoma: Colon & Rectal Cancer: Home Testing Home Colorectal Cancer Tests Home Fecal Occult Bleeding Tests High Cholesterol: Home Testing: Home Cholesterol Tests Home Triglycerides Tests Home Blood Pressure Tests High Blood Pressure: Home Testing Home Blood Pressure Monitors Home Heart Tests Heart Health: Home Testing: Heart Rate Monitors Irregular Heartbeat Detection Heart Electrocardiogram (ECG) Thyroid: Home Testing: Home Thyroid Function Tests Home TSH Tests Home Adrenal Function Tests


Medical therapy is indicated in patients with malignant insulinomas and in those who will not or cannot undergo surgery. These measures are designed to prevent hypoglycemia and, in patients with malignant tumors, to reduce the tumor burden. In malignant insulinomas, dietary therapy with frequent oral feedings or enteral feedings may control mild symptoms of hypoglycemia. A trial of glucagon may be attempted to control hypoglycemia. Diazoxide is related to the thiazide diuretics and reduces insulin secretion. Adverse effects include sodium retention, a tendency to congestive cardiac failure, and hirsutism. Prescribe hydrochlorothiazide to counteract the edema and hyperkalemia secondary to diazoxide and to potentate its hyperglycemic effect. Of patients with insulinoma, 50% may benefit from the somatostatin analogue octreotide to prevent hypoglycemia.14 The effect of the therapy depends on the presence of somatostatin receptor subtype 2 on insulinoma tumor cells. As studies have shown, an OctreoScan is not a prerequisite before starting octreotide treatment. In patients with insulinoma and a negative scan finding, somatostatin decreased insulin levels significantly and lowered the incidence of hypoglycemic events. Surgical Care Because insulinoma resection achieves cure in 90% of patients, it is currently the therapy of choice. Preoperative management Administer diazoxide on the day of surgery in patients who respond to it. Diazoxide reduces the need for glucose supplements and the risk of hypoglycemia. Monitor blood glucose level throughout surgery. Infuse 10% dextrose in water at a rate of at least 100 mL/h. A preoperative trial with diazoxide is indicated to determine whether the patient is a responder. (Five to 10% of patients do not respond.) This information helps determine the intraoperative strategy if the tumor is not localized. In MEN 1, hypercalcemia must be corrected first by parathyroidectomy before insulinoma resection.15