Clinical review for general practice

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FULLSCREEN > Archive > 2024 > Clinical case of diagnosis and treatment of insulinoma

Clinical case of diagnosis and treatment of insulinoma

Natalia A. Nikitina , Artyom V. Snitsar , Marina V. Kuandykova , Konstantin A. Pokrovsky , Sergey A. Yerin , Vyacheslav A. Shibitov , Natalia V. Brevnova , Nina A. Petunina

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Abstract

Insulinoma is a rare neuroendocrine pancreatic tumor that typically produces excessive amout of hormone insulin. The main clinical manifestations of insulinoma are episodes of hypoglycemia. The low prevalence of the disease, the complexity of clinical and laboratory diagnosis, as well as the difficulty of topical diagnosis, low awareness physicians of related specialties, often cause untimely diagnosis of the disease, which worsens patients life-quality and prognosis. This article presents a clinical case of diagnosis and treatment of insulinoma in a non-specialized hospital. The article describes the methods of laboratory and topical diagnostics, as well as treatment tactics of patients with this disease. 
Keywords: insulinoma, hypoglycemia, hypoglycemis syndrome, hyperinsulinism, neuroendocrine pancreatic tumor.

About the Author

Natalia A. Nikitina 1 , Artyom V. Snitsar 1 , Marina V. Kuandykova 1 , Konstantin A. Pokrovsky 2 , Sergey A. Yerin 1 , Vyacheslav A. Shibitov 1 , Natalia V. Brevnova 1 , Nina A. Petunina 3

1 City Clinical Hospital named after M.E. Zhadkevic, Moscow Health Department, Moscow, Russia

2 Moscow Heath Department, Moscow, Russia

3 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

References

1. Недиабетические гипогликемии. Проект клинических рекомендаций. Обновленная версия. URL: https://rae-org.ru/system/files/documents/pdf/cr_ndm_hyp_2023 Nondiabetic hypoglycemia. Draft clinical guidelines. Updated version. URL: https://rae-org.ru/system/files/documents/pdf/cr_ndm_hyp_ 2023 (in Russian).
2. Service FJ , McMahon MM, O'Brien PC, Ballard DJ. Functioning insulinoma – incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin Proc. 1991;66(7):711-9. 
3. Юкина М.Ю., Нуралиева Н.Ф., Трошина Е.А. и др. Гипогликемический синдром (инсулинома): патогенез, этиология, лабораторная диагностика. Обзор литературы (часть 1). Проблемы эндокринологии. 2017;63(4):245-56. Yukina M.Yu., Nuralieva N.F., Troshina E.A. et al. Hypoglycemic syndrome (insulinoma): pathogenesis, etiology, laboratory diagnostics. Literature review (part 1). Problems of endocrinology. 2017;63(4):245-56. (in Russian).
4. Cryer PE, Axelrod L, Grossman AB et al. Evaluation and management of adult hypoglycemic disorders: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2009;94(3):709-28. DOI: 10.1210/jc.2008-1410
5. Kaltsas GA, Besser GM, Grossman AB. The diagnosis and medical management of advanced neuroendocrine tumors. Endocr Rev. 2004;25:
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6. Service FJ, O'Brien PC, McMahon MM, Kao PC. C-peptide during the prolonged fast in insulinoma. J Clin Endocrinol Metab. 1993;76(3):655-9.
7. Okabayashi T, Shima Y, Sumiyoshi T et al. Diagnosis and management of insulinoma. World J Gastroenterol. 2013;19(6):829-37.
8. Егоров А.В., Мусаев Г.Х., Фоминых Е.В. и др. Эволюция алгоритма топической диагностики гормонально-активных нейроэндокринных опухолей поджелудочной железы. Анналы хирургической гепатологии. 2016;21(1):21-7. Egorov A.V., Musaev G.H., Fomin E.V. et al.  Evolution of the algorithm for topical diagnosis of hormone-active neuroendocrine tumors of the pancreas. Annals of surgical hepatology. 2016;21(1):21-7 (in Russian).
9. Noone TC, Hosey J, Firat Z, Semelka RC. Imaging and localization of islet-cell tumours of the pancreas on CT and MRI. Best Pract Res Clin Endocrinol Metab. 2005 Jun;19(2):195-211
10. Tucker ON, Crotty PL, Conlon KC. The management of insulinoma. British J Surgery. 2006;93(3):264-75.
11. de Carbonnières A, Challine A, Cottereau AS et al. Surgical management of insulinoma over three decades. HPB (Oxford). 2021;23(12):1799-806.

For citation:Nikitina N.A., Snitsar’ A.V., Kuandykova M.V., Pokrovsky K.A., Yerin S.A., Shibitov B.A., Brevnova N.B., Petunina N.A. Clinical case of diagnosis and treatment of insulinoma. Clinical analysis in general medicine. 2024; 5 (7): 97–102 (In Russ.). DOI: 10.47407/kr2024. 5.7.00p423


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