Pancreas

Question 1

What is the most common functioning tumor of the endocrine pancreas?

Answer 1

Insulinoma

Insulinoma is the most prevalent functioning tumor found in the endocrine part of the pancreas.

Question 2

What is the average age at diagnosis for insulinoma?

Answer 2

45 years

The average age at which patients are diagnosed with insulinoma is 45.

Question 3

What is the typical size range for insulinomas?

Answer 3

1.0 to 1.5 cm

Insulinomas are generally small tumors, averaging between 1.0 to 1.5 cm in size.

Question 4

What is Whipple’s triad?

Answer 4

Symptoms of hypoglycemia + Low blood glucose levels (40-50 mg/dL) + Relief of symptoms after glucose administration

Whipple’s triad is the diagnostic hallmark for insulinoma, consisting of three key components.

Question 5

List the symptoms associated with fasting-induced neuroglycopenic symptoms of hypoglycemia.

Answer 5

• Diaphoresis
• Shaking
• Mental confusion
• Obtundation
• Seizures

These symptoms are indicative of hypoglycemia experienced by patients with insulinoma.

Question 6

What percentage of insulinomas are located in the pancreas?

Answer 6

97%

The majority of insulinomas, 97%, are found in the pancreas, with equal distribution across its head, body, and tail.

Question 7

What are some symptoms of sympathetic overactivity in response to hypoglycemia?

Answer 7

• Fatigue
• Weakness
• Fearfulness
• Hunger
• Tremor
• Diaphoresis

Patients may exhibit various sympathetic symptoms during hypoglycemic episodes.

Question 8

What is the gold standard test for diagnosing insulinoma?

Answer 8

72-hour fasting test

The 72-hour fasting test is the most reliable method for diagnosing insulinoma.

Question 9

What insulin-to-glucose ratio is consistent with insulinoma?

Answer 9

> 0.4

An insulin-to-glucose ratio greater than 0.4 indicates a likelihood of insulinoma.

Question 10

What imaging techniques are used for insulinoma localization?

Answer 10

• CECT or MRI
• Angiography
• EUS with intra-operative palpation

These imaging modalities help localize insulinomas effectively.

Question 11

What is the treatment for insulinoma once diagnosed?

Answer 11

• Laparoscopic resection
• Enucleation

Insulinomas are generally treated through surgical methods like laparoscopic resection or enucleation.

Question 12

What is the first-line treatment option for insulinoma located in the head of the pancreas?

Answer 12

Enucleation

Enucleation is the preferred surgical approach for insulinomas found in the head of the pancreas.

Question 13

What surgical approach is used for insulinoma located in the body or tail of the pancreas?

Answer 13

Distal pancreatectomy

Distal pancreatectomy is the standard surgical method for insulinomas situated in the body or tail of the pancreas.

Question 14

What medication decreases beta cell release of insulin in insulinoma patients?

Answer 14

Diazoxide

Diazoxide is used to manage hypoglycemic symptoms prior to surgical intervention.

Question 15

True or False: Insulinoma is a painful condition.

Answer 15

False

Insulinoma is typically a painless condition.

Question 16

What treatment has been associated with improved survival in metastatic pancreatic endocrine tumors?

Answer 16

Streptozotocin, with or without 5-fluorouracil

This combination therapy has shown benefits for patients with metastatic pancreatic endocrine tumors.