Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1979 Jun;189(6):677–682. doi: 10.1097/00000658-197906000-00002

The surgical aspects of insulinomas.

J A van Heerden, A J Edis, F J Service
PMCID: PMC1397228  PMID: 222222

Abstract

The clinical diagnosis of insulinoma rests on the demonstration of Whipple's triad (symptoms of hypoglycimia, low circulating glucose and prompt relief of symptoms after glucose administration). Biochemically, the association of an increased value of immunoreactive insulin with a low glucose value is diagnostic of insulin-mediated hypoglycemia. Angiographic localization of these tumors is accomplished in more than 90% of cases. The pathologic changes are usually due to a single adenoma, for which surgical enucleation is the procedure of choice. Malignancy and persistent hypoglycemia occur in slightly less than 10% of cases and can be fairly successfully managed by diazoxide and streptozotocin.

Full text

PDF
677

Images in this article

678Fig. 1.
on p.678
679Fig. 2.
on p.679

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Broder L. E., Carter S. K. Pancreatic islet cell carcinoma. II. Results of therapy with streptozotocin in 52 patients. Ann Intern Med. 1973 Jul;79(1):108–118. doi: 10.7326/0003-4819-79-1-108. [DOI] [PubMed] [Google Scholar]
  2. Edis A. J., McIlrath D. C., Van Heerden J. A., Fulton R. E., Sheedy P. F., Service F. J., Dale A. J. Insulinoma--current diagnosis and surgical management. Curr Probl Surg. 1976 Oct;13(10):1–45. doi: 10.1016/s0011-3840(76)80010-x. [DOI] [PubMed] [Google Scholar]
  3. Laroche G. P., Erris D. O., Priestley J. T., Scholz D. A., Dockerty M. B. Hyperinsulinism. Surgical results and management of occult functioning islet cell tumor: review of 154 cases. Arch Surg. 1968 May;96(5):763–772. doi: 10.1001/archsurg.1968.01330230071009. [DOI] [PubMed] [Google Scholar]
  4. MARKOWITZ A. M., SLANETZ C. A., Jr, FRANTZ V. K. Functioning islet cell tumors of the pancreas. 25-year follow up. Ann Surg. 1961 Dec;154:877–884. [PMC free article] [PubMed] [Google Scholar]
  5. McMILLAN F. L., SCHEIBE J. R. Islet cell tumor of the pancreas. Am J Surg. 1951 Dec;82(6):759–761. doi: 10.1016/0002-9610(51)90404-7. [DOI] [PubMed] [Google Scholar]
  6. PRIESTLEY J. T. Hyperinsulinism. Ann R Coll Surg Engl. 1962 Oct;31:211–228. [PMC free article] [PubMed] [Google Scholar]
  7. Schnelle N., Molnar G. D., Ferris D. O., Rosevear J. W., Moffitt E. A. Circulating glucose and insulin in surgery for insulomas. JAMA. 1971 Aug 23;217(8):1072–1078. [PubMed] [Google Scholar]
  8. Service F. J., Dale A. J., Elveback L. R., Jiang N. S. Insulinoma: clinical and diagnostic features of 60 consecutive cases. Mayo Clin Proc. 1976 Jul;51(7):417–429. [PubMed] [Google Scholar]
  9. Service F. J., Horwitz D. L., Rubenstein A. H., Kuzuya H., Mako M. E., Reynolds C., Molnar G. D. C-peptide suppression test for insulinoma. J Lab Clin Med. 1977 Jul;90(1):180–186. [PubMed] [Google Scholar]
  10. Service F. J., Palumbo P. J. Factitial hypoglycemia. Three cases diagnosed on the basis of insulin antibodies. Arch Intern Med. 1974 Aug;134(2):336–340. doi: 10.1001/archinte.134.2.336. [DOI] [PubMed] [Google Scholar]
  11. Turner R. C., Lee E. C., Morris P. J., Harris E. A. Localisation of insulinomas. Lancet. 1978 Mar 11;1(8063):515–518. doi: 10.1016/s0140-6736(78)90548-2. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES