insulinoma

Introduction

most common pancreatic endocrine tumour
10% malignant, 10% multiple
of patients with multiple tumours, 50% have MEN-1

Presentation

Usually with symptoms of hypoglycaemia: typically early in morning or just before meal, e.g. diplopia, weakness etc
rapid weight gain may be seen

Laboratory investigations

high insulin, raised proinsulin:insulin ratio
high C-peptide

Other investigatins

Supervised, prolonged fasting (up to 72 hours) - most important investigations
CT pancreas

Management

surgery
diazoxide and somatostatin if patients are not candidates for surgery

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