Insulinoma Flashcards
1
Q
What is an insulinoma?
A
It is an often benign pancreatic islet cell tumour that is seen with MEN-1 syndrome
2
Q
How do insulinoma’s present?
A
It presents as fasting hypoglycaemia, with Whipple’s triad
3
Q
What is Whipple’s triad?
A
- Symptoms associated with fasting or exercise
- Recorded hypoglycaemia with symptoms
- Symptoms relieved with glucose.
4
Q
What are the screening tests for insulinoma?
A
Hypoglycaemia + plasma insulin increase during a long fast.
5
Q
What are the suppressive tests for insulinomas?
A
Give IV insulin and measure C-peptide.
Normally exogenous insulin suppresses C-peptide production, but this does not occur in insulinoma.
6
Q
What imaging techniques are used for insulinoma?
A
- CT/MRI ± endoscopic pancreatic
- US ± IACS (see BOX; all fallible, so don’t waste too much time before proceeding to intra-operative visualization ± intra-operative ultrasound).
- 18F-L-3,4-dihydroxyphenylalanine PET-CT can help guide laparoscopic surgery.
7
Q
How are insulinoma’s treated?
A
Excision
