Insulinoma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

• There is no established system for the classification of [disease name].

OR

• [Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].

OR

• [Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3].
• [Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].

OR

• Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.

OR

• If the staging system involves specific and characteristic findings and features:
• According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].

OR

• The staging of [malignancy name] is based on the [staging system].

OR

• There is no established system for the staging of [malignancy name].

Classification

• Insulinoma may be classified according to malignant potential into 2 sub-types:
  • Benign
  • Malignant
    • 90% of insulinoma are benign in nature while 10% has a malignant potential to invade adjacent soft tissues or structures. The malignant type is mostly associated with MEN 1 syndrome.They also have a recurrence rate which is higher in those with MEN1 (21% at 10 and 20 years) than without it(5% at 10 and 7% at 20 years)

• Previously insulinoma was classified into 2 subtypes based on hormonal level as determined by radioimmunoassay:
  • Group A of abundant B cells with trabecular arrangement and uniform insulin immunofluorescence
  • Group B of scarce B cells with medullary arrangement and irregular immunofluorescence
• Insulinoma being a pancreatic neuroendocrine tumor may be classified/staged into several subtypes based on American Joint Cancer Committee(AJCC) 7th edition 2010: