Clinical Management of Malignant Insulinoma: a single Institution’s experience over three decades
Abstract Background Malignant insulinoma is extremely rare and accounts for only 10% of total insulinoma cases. The goal of this study is to retrospectively analyze clinical data from 15 patients with malignant insulinoma treated at Peking Union Medical College Hospital (PUMCH) from 1984 to April 20...
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | BMC Endocrine Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12902-018-0321-8 |
| _version_ | 1818482824206876672 |
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| author | Jie Yu Fan Ping Huabing Zhang Wei Li Tao Yuan Yong Fu Kai Feng Weibo Xia Lingling Xu Yuxiu Li |
| author_facet | Jie Yu Fan Ping Huabing Zhang Wei Li Tao Yuan Yong Fu Kai Feng Weibo Xia Lingling Xu Yuxiu Li |
| author_sort | Jie Yu |
| collection | DOAJ |
| description | Abstract Background Malignant insulinoma is extremely rare and accounts for only 10% of total insulinoma cases. The goal of this study is to retrospectively analyze clinical data from 15 patients with malignant insulinoma treated at Peking Union Medical College Hospital (PUMCH) from 1984 to April 2017. Methods “Malignant insulinoma” was used as the keywords in the PUMCH medical record retrieval system to search and obtain patients’ clinical information. We identified subjects diagnosed with malignant insulinoma based on clinical or surgical pathological signs and subsequently analyzed their clinical data. Results Eight males and seven females with a median age at diagnosis of 40 years (38–54 years) were included. Eight patients (53%) had developed metastases at diagnosis, while the others (46.67%) developed metastases during the follow-up visits. The major sites of metastasis were the liver (86.7%), local tissues and blood vessels (33%) and abdominal lymph nodes (13%). All patients displayed neuroglycopenic (100%) and/or autonomic (60%) symptoms, mostly during fasting periods (73.3%), with an average blood glucose level of 1.66 ± 0.51 mmol/L. A total of 93% of the patients had one primary pancreatic lesion, 53% had a lesion in the head of the pancreas, and 47% had a lesion in the tail of the pancreas, with diameters ranging between 0.9 and 6.0 cm. Most liver metastases were multiple lesions. Selective celiac arteriography yielded 100% sensitivity for both primary pancreatic lesions and liver metastases. Most patients received synthetical treatments, including surgery, chemoembolization, and octreotide. Conclusions Malignant insulinomas have a similar diagnostic process to that of benign insulinomas but require far more comprehensive therapies to alleviate hypoglycemic symptoms and extend patients’ survival. |
| first_indexed | 2024-12-10T11:51:47Z |
| format | Article |
| id | doaj.art-7ca020d80c1c4bd98aee2016530d4a69 |
| institution | Directory Open Access Journal |
| issn | 1472-6823 |
| language | English |
| last_indexed | 2024-12-10T11:51:47Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Endocrine Disorders |
| spelling | doaj.art-7ca020d80c1c4bd98aee2016530d4a692022-12-22T01:49:55ZengBMCBMC Endocrine Disorders1472-68232018-12-011811710.1186/s12902-018-0321-8Clinical Management of Malignant Insulinoma: a single Institution’s experience over three decadesJie Yu0Fan Ping1Huabing Zhang2Wei Li3Tao Yuan4Yong Fu5Kai Feng6Weibo Xia7Lingling Xu8Yuxiu Li9Department of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College HospitalDepartment of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College HospitalDepartment of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College HospitalDepartment of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College HospitalDepartment of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College HospitalDepartment of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College HospitalDepartment of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College HospitalDepartment of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College HospitalDepartment of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College HospitalDepartment of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College HospitalAbstract Background Malignant insulinoma is extremely rare and accounts for only 10% of total insulinoma cases. The goal of this study is to retrospectively analyze clinical data from 15 patients with malignant insulinoma treated at Peking Union Medical College Hospital (PUMCH) from 1984 to April 2017. Methods “Malignant insulinoma” was used as the keywords in the PUMCH medical record retrieval system to search and obtain patients’ clinical information. We identified subjects diagnosed with malignant insulinoma based on clinical or surgical pathological signs and subsequently analyzed their clinical data. Results Eight males and seven females with a median age at diagnosis of 40 years (38–54 years) were included. Eight patients (53%) had developed metastases at diagnosis, while the others (46.67%) developed metastases during the follow-up visits. The major sites of metastasis were the liver (86.7%), local tissues and blood vessels (33%) and abdominal lymph nodes (13%). All patients displayed neuroglycopenic (100%) and/or autonomic (60%) symptoms, mostly during fasting periods (73.3%), with an average blood glucose level of 1.66 ± 0.51 mmol/L. A total of 93% of the patients had one primary pancreatic lesion, 53% had a lesion in the head of the pancreas, and 47% had a lesion in the tail of the pancreas, with diameters ranging between 0.9 and 6.0 cm. Most liver metastases were multiple lesions. Selective celiac arteriography yielded 100% sensitivity for both primary pancreatic lesions and liver metastases. Most patients received synthetical treatments, including surgery, chemoembolization, and octreotide. Conclusions Malignant insulinomas have a similar diagnostic process to that of benign insulinomas but require far more comprehensive therapies to alleviate hypoglycemic symptoms and extend patients’ survival.http://link.springer.com/article/10.1186/s12902-018-0321-8Malignant insulinomaMetastasisHyperinsulinismHypoglycemiaDiagnosisTherapeutics |
| spellingShingle | Jie Yu Fan Ping Huabing Zhang Wei Li Tao Yuan Yong Fu Kai Feng Weibo Xia Lingling Xu Yuxiu Li Clinical Management of Malignant Insulinoma: a single Institution’s experience over three decades BMC Endocrine Disorders Malignant insulinoma Metastasis Hyperinsulinism Hypoglycemia Diagnosis Therapeutics |
| title | Clinical Management of Malignant Insulinoma: a single Institution’s experience over three decades |
| title_full | Clinical Management of Malignant Insulinoma: a single Institution’s experience over three decades |
| title_fullStr | Clinical Management of Malignant Insulinoma: a single Institution’s experience over three decades |
| title_full_unstemmed | Clinical Management of Malignant Insulinoma: a single Institution’s experience over three decades |
| title_short | Clinical Management of Malignant Insulinoma: a single Institution’s experience over three decades |
| title_sort | clinical management of malignant insulinoma a single institution s experience over three decades |
| topic | Malignant insulinoma Metastasis Hyperinsulinism Hypoglycemia Diagnosis Therapeutics |
| url | http://link.springer.com/article/10.1186/s12902-018-0321-8 |
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