Insulinoma natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Insulinoma}} | {{Insulinoma}} | ||
{{CMG}}; {{AE | {{CMG}}; {{AE}} | ||
==Overview== | ==Overview== | ||
If left untreated, patients with insulinoma may progress to develop [[seizures]], [[coma]] and may be even death.Prognosis is generally excellent for benign insulinoma after the removal of the tumor. Recurrence rates are higher in those associated with [[MEN1]] syndrome. | If left untreated, patients with insulinoma may progress to develop [[seizures]], [[coma]] and may be even death. Prognosis is generally excellent for benign insulinoma after the removal of the tumor. Recurrence rates are higher in those associated with [[MEN1]] syndrome. | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
*The symptoms of | *The symptoms of insulinoma are found in any age group and start with neuroglycopenic symptoms such as altered mental status, visual disturbances, confusion and adrenergic symptoms such as profuse sweating, palpitations and tremors. | ||
*If left untreated, hypoglycemia progresses in frequency, although the tumor size remains small.<ref name="urlNatural History of Untreated Insulinoma over a Course of 7 Years : Endocrine Neoplasia: Tumorigenesis and Therapeutics">{{cite web |url=http://press.endocrine.org/doi/abs/10.1210/endo-meetings.2015.TB.2.THR-316 |title=Natural History of Untreated Insulinoma over a Course of 7 Years : Endocrine Neoplasia: Tumorigenesis and Therapeutics |format= |work= |accessdate=}}</ref> | *If left untreated, hypoglycemia progresses in frequency, although the tumor size remains small.<ref name="urlNatural History of Untreated Insulinoma over a Course of 7 Years : Endocrine Neoplasia: Tumorigenesis and Therapeutics">{{cite web |url=http://press.endocrine.org/doi/abs/10.1210/endo-meetings.2015.TB.2.THR-316 |title=Natural History of Untreated Insulinoma over a Course of 7 Years : Endocrine Neoplasia: Tumorigenesis and Therapeutics |format= |work= |accessdate=}}</ref> | ||
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*90% insulinomas are benign and they are generally cured after the removal of the tumor, so benign insulinoma is associated with the most favorable prognosis.<ref name="pmid1677058">{{cite journal| author=Service FJ, McMahon MM, O'Brien PC, Ballard DJ| title=Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study. | journal=Mayo Clin Proc | year= 1991 | volume= 66 | issue= 7 | pages= 711-9 | pmid=1677058 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1677058 }} </ref> | *90% insulinomas are benign and they are generally cured after the removal of the tumor, so benign insulinoma is associated with the most favorable prognosis.<ref name="pmid1677058">{{cite journal| author=Service FJ, McMahon MM, O'Brien PC, Ballard DJ| title=Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study. | journal=Mayo Clin Proc | year= 1991 | volume= 66 | issue= 7 | pages= 711-9 | pmid=1677058 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1677058 }} </ref> | ||
*The prognosis varies with the malignant potential of the tumor; Grade 1 and 2 tumor have the most favorable prognosis. | *The prognosis varies with the malignant potential of the tumor; Grade 1 and 2 tumor have the most favorable prognosis. | ||
*Malignant insulinomas : In a study of 10 patients, the first 4 who presented with lymph node metastasis and, after surgical excision, maintained a prolonged tumor-free survival. Second, four patients presented with metastatic disease to the liver, which appeared years after the initial diagnosis and presumed curative surgery. Third, one patient presented with a large �-fetoprotein-secreting liver mass. Finally, 9 of the 10 patients had a prolonged survival. | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
If left untreated, patients with insulinoma may progress to develop seizures, coma and may be even death. Prognosis is generally excellent for benign insulinoma after the removal of the tumor. Recurrence rates are higher in those associated with MEN1 syndrome.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of insulinoma are found in any age group and start with neuroglycopenic symptoms such as altered mental status, visual disturbances, confusion and adrenergic symptoms such as profuse sweating, palpitations and tremors.
- If left untreated, hypoglycemia progresses in frequency, although the tumor size remains small.[1]
Complications
- Common complications of insulinoma include those with hypoglycemia:
Prognosis
- 90% insulinomas are benign and they are generally cured after the removal of the tumor, so benign insulinoma is associated with the most favorable prognosis.[3]
- The prognosis varies with the malignant potential of the tumor; Grade 1 and 2 tumor have the most favorable prognosis.
- Malignant insulinomas : In a study of 10 patients, the first 4 who presented with lymph node metastasis and, after surgical excision, maintained a prolonged tumor-free survival. Second, four patients presented with metastatic disease to the liver, which appeared years after the initial diagnosis and presumed curative surgery. Third, one patient presented with a large �-fetoprotein-secreting liver mass. Finally, 9 of the 10 patients had a prolonged survival.
References
- ↑ "Natural History of Untreated Insulinoma over a Course of 7 Years : Endocrine Neoplasia: Tumorigenesis and Therapeutics".
- ↑ Graves TD, Gandhi S, Smith SJ, Sisodiya SM, Conway GS (2004). "Misdiagnosis of seizures: insulinoma presenting as adult-onset seizure disorder". J Neurol Neurosurg Psychiatry. 75 (8): 1091–2. doi:10.1136/jnnp.2003.029249. PMC 1739168. PMID 15258206.
- ↑ Service FJ, McMahon MM, O'Brien PC, Ballard DJ (1991). "Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study". Mayo Clin Proc. 66 (7): 711–9. PMID 1677058.