Insulinoma

Insulinoma is a pancreatic islet B-cell tumor, also called endogenous hyperinsulinism, a common cause of organic hypoglycemia, accounting for 70-75% of islet cell tumors. Most are benign; malignant ones account for 10-16%. It can occur at any age but favors young/middle-aged adults (74.6% at 20-59 years), with male predominance (M:F 1.4-2.1).

Common Symptoms

Coma; hypoglycemia; tremor; diarrhea; convulsion; tachycardia; palpitations; hepatomegaly

Causes

The primary defect is storage: insulinoma cells synthesize insulin and respond to stimuli but partially/completely lose the ability to store it. Normally, blood glucose is maintained by insulin/glucagon balance; when glucose falls, glucagon rises and insulin is suppressed — at 1.96 mmol/L (35 mg%) insulin secretion nearly stops. In insulinoma this feedback is lost, so insulin is continuously released and suppresses hepatic glycogenolysis beyond demand, causing hypoglycemia. Hypoglycemia triggers compensatory catecholamine release (tachycardia, hypertension, palpitations, sweating). Tumors occur anywhere in the pancreas (head/body/tail roughly equal, slightly more in tail); usually small (0.5-5 cm, >80% <2 cm), making localization difficult. Most are spherical with ill-defined capsules, soft, vascular; intraoperative appearance is reddish-brown/blue-purple. About 50% are pure beta-cell tumors; others are mixed alpha/delta/PP/G-cell tumors. Histology: cells in cords/nests, polygonal/cuboidal/columnar, with granular cytoplasm, round/oval nuclei, rare mitoses; stroma has amyloid deposition.

Treatment

Drug therapy; surgery; rehabilitation

Prevention

No effective prevention; early detection and diagnosis are key. Hypoglycemia is the underlying cause of symptoms; attacks occur on waking, fasting, exertion or stress, initially at long intervals then becoming frequent. Actively prevent hypoglycemia.

Recommended Department

It is recommended to visit the oncological surgery department; before the visit you may first book an appointment and connect with experts through this platform.

Warm reminder: The above information is provided for health education reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek care at a regular hospital in time.