Category: Pituitary Disorders/Neuroendocrinology
To describe the clinical, diagnostic, anatomo-pathological and follow-up characteristics of patients with insulinoma in the Hospital Edgardo Rebagliati (Lima-Peru) during the 2008-2018 period.
All patients diagnosed with Insulinoma, seen at the hospital during the study period, were evaluated. Clinical records were reviewed and patients older than 18 years were included, who met the diagnostic criteria of insulinoma (clinical, laboratory and imaging). They were consigned in data collection forms. The variables are presented using measures of central tendency.
Results : We studied 20 patients diagnosed with insulinoma, 14 women (70%), average age of 60.7 years; 35% were overweight and 45% obese. All cases were insulinomas not associated with NEM. The mean illness time was 45.5 months, 5% had isolated adrenergic symptoms, 40% isolated neuroglucopenic and 55% mixed. 80% had symptoms in fasting. A positive fasting test was recorded in 95% of patients, with glucose means: 35.6mg / dl, insulin: 50.7μU / mL and C-peptide: 12.1μU / mL (Criteria for hyperinsulinemic hypoglycemia). 94.7% of insulinomas had an insulin / glucose ratio> 0.3 and 73.6% had a Turner index> 50. 75% were placed with images (CT, MRI and/or echo-endoscopy) and in the rest by the intra-arterial calcium stimulation test. 20% were multiple and 15% were metastatic. The most common surgical technique was laparoscopic subtotal pancreatectomy with 75% healing.
Insulinoma is usually a benign, solitary tumor predominantly in women, which meets criteria for hyperinsulinemic hypoglycemia, being localized by pancreatic CT and the intra-arterial calcium stimulation test. Its management requires specialized multidisciplinary work. Survival is high considering postoperative morbidity.
Conclusion : Insulinoma, a neoplasm characterized by the proliferation of pancreatic B cells, is the most frequent cause of tumor hypoglycaemia in our hospital.
Jose PAZ-IBARRA– ENDOCRINOLOGIST, HOSPITAL NACIONAL EDGARDO REBAGLIATI - UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS. LIMA - PERU, Lima, Lima, Peru
Karen Salirrosas– ENDOCRINOLOGY RESIDENT, HOSPITAL REBAGLIATI - LIMA - PERU, Lima, Peru
Julia Salcedo– ENDOCRINOLOGY RESIDENT, HOSPITAL REBAGLIATI - LIMA - PERU
Maria Churampi– ENDOCRINOLOGIST, HOSPITAL REBAGLIATI - LIMA - PERU, Lima, Peru
HOSPITAL NACIONAL EDGARDO REBAGLIATI - UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS. LIMA - PERU
Lima, Lima, Peru
PERUVIAN ENDOCRINOLOGIST, UNIVERSITY TEACHER, ACTIVE MEMBER OF AACE, AREAS OF INTEREST NEUROENDOCRINOLOGY, THYROID, ENDOCRINOLOGY OF REPRODUCTION AND BONE MINERAL METABOLISM
HOSPITAL REBAGLIATI - LIMA - PERU, Lima, Peru
RESIDENT IN ENDOCRINOLOGY
HOSPITAL REBAGLIATI - LIMA - PERU
RESIDENT IN ENDOCRINOLOGY