Insulinoma
Insulinoma is a tumor that develops in the pancreas. The pancreas is an organ of the digestive system that produces insulin, a hormone. The body needs insulin to regulate blood sugar. Under normal conditions, the pancreas produces insulin only when the body needs it. Insulin production will increase when glucose (glucose) levels increase in the blood and will decrease if glucose levels are low.
But in patients with insulinoma, insulin continues to be produced by the pancreas without being affected by blood sugar. This condition can cause hypoglycemia (lower than normal glucose levels), accompanied by symptoms such as dizziness, blurred vision and loss of consciousness.
Insulinoma is classified as a rare tumor and its treatment is performed surgically to remove the tumor. After the tumor causes the insulinoma to be removed, the patient's condition will recover.
Symptoms of insulin
The symptoms of insulinoma vary from mild to severe, depending on the severity of the disease. Although the symptoms of insulinoma are rather difficult to know, the symptoms of this disease are usually as follows:
In severe conditions, seizures can occur. Tumors also disrupt the work of the brain and adrenal glands, which play a role in regulating heart rate and stress. In addition to seizures, symptoms of severe insulinoma can range from palpitations to coma.
Although rare, tumors can grow and spread to other parts of the body. In this condition, symptoms of insulunioma may include diarrhea, abdominal or back pain and jaundice.
Causes of insulinoma
The cause of insulinoma is not known with certainty. This tumor is more common in women than men. The vulnerable age for this tumor is 40 to 60 years.
Although the exact cause is unknown, the following factors can increase the risk of insulinoma:
Multiple endocrine neoplasia type 1 or Werner syndrome, a rare disease in which tumors develop in the endocrine glands, intestine and stomach.
Neurofibromatosis type 1, which is a genetic disease that causes slowing of cell growth, so that tumors develop in nerve tissue and skin.
Tuberous sclerosis, a non-cancerous tumor that develops in many places, such as the brain, eyes, heart, kidneys, lungs or skin.
Von Hippel-Lindau syndrome, a genetic disorder that causes the growth of a group of tumors or cysts (fluid-filled sacs) in a number of organs, such as the adrenal glands, pancreas, kidneys, and urinary lymphatic pathways.
Diagnosis of insulinoma
The symptoms that appear will form the basis on which the doctor suspects the patient has insulinoma.
Besides checking the patient's symptoms, the doctor will also confirm the diagnosis by conducting a blood test to check blood sugar and insulin levels. The blood test aims to see:
If the results of the blood test lead to insulinoma, the doctor will recommend further tests. In this follow-up examination, the patient will be asked to fast for 48 to 72 hours. The patient will be hospitalized so the doctor can continue to monitor blood sugar levels. The doctor will monitor the patient's sugar and insulin levels every 6 hours. The examination ratio will be evaluated by a doctor and will be the basis for the diagnosis of insulinoma. CT scan or MRI is also used to help doctors determine the location and size of the tumor.
If the tumor cannot be found through both procedures, the diagnosis can be done by endoscopic ultrasound. In this procedure, the doctor will insert a special instrument in the form of a flexible tube long enough in the mouth to reach the patient's stomach and small intestine. This tool will produce and convert sound waves into visual images to see conditions in the stomach, especially the pancreas.
After the location of the tumor is found, the doctor can take a small amount of tumor tissue as a sample. This sample can then be used to determine whether the tumor in the pancreas is cancerous or not.
Treatment and prevention of insulinoma
Surgery is the main step in the treatment of insulinoma. This technique can be done in the form of laparoscopy and open surgery. Laparoscopy is done if only one tumor develops. During laparoscopy, the surgeon will make a small incision in the patient's abdomen and insert a special instrument in the form of a tube with a small camera on the end, which will help the doctor remove the tumor.
At the same time, in insulinomas with several tumors, open surgery is performed to remove the part of the pancreas that attacks the tumor. At a minimum, the pancreas must leave 25% to maintain pancreatic function in the production of digestive food enzymes.
Ten percent of insulinomas are malignant (cancer), so surgical removal of the tumor is not enough to treat it. Additional treatments for treating malignant insulinoma are:
The following complications related to insulinoma can occur:
Prevention of insulinoma
Prevention of this disease is not yet known. However, you can make efforts to keep your blood glucose levels within normal limits. These efforts include reducing consumption of red meat, consumption of fruits and vegetables, regular exercise and stopping smoking.
Insulinoma is classified as a rare tumor and its treatment is performed surgically to remove the tumor. After the tumor causes the insulinoma to be removed, the patient's condition will recover.
Symptoms of insulin
The symptoms of insulinoma vary from mild to severe, depending on the severity of the disease. Although the symptoms of insulinoma are rather difficult to know, the symptoms of this disease are usually as follows:
- dizzy
- low
- sweating
- very hungry
- Blurred or double vision
- Sudden weight gain
- Mood often changes
- Feeling confused, anxious and easily offended
- Tremble (tremble).
In severe conditions, seizures can occur. Tumors also disrupt the work of the brain and adrenal glands, which play a role in regulating heart rate and stress. In addition to seizures, symptoms of severe insulinoma can range from palpitations to coma.
Although rare, tumors can grow and spread to other parts of the body. In this condition, symptoms of insulunioma may include diarrhea, abdominal or back pain and jaundice.
Causes of insulinoma
The cause of insulinoma is not known with certainty. This tumor is more common in women than men. The vulnerable age for this tumor is 40 to 60 years.
Although the exact cause is unknown, the following factors can increase the risk of insulinoma:
Multiple endocrine neoplasia type 1 or Werner syndrome, a rare disease in which tumors develop in the endocrine glands, intestine and stomach.
Neurofibromatosis type 1, which is a genetic disease that causes slowing of cell growth, so that tumors develop in nerve tissue and skin.
Tuberous sclerosis, a non-cancerous tumor that develops in many places, such as the brain, eyes, heart, kidneys, lungs or skin.
Von Hippel-Lindau syndrome, a genetic disorder that causes the growth of a group of tumors or cysts (fluid-filled sacs) in a number of organs, such as the adrenal glands, pancreas, kidneys, and urinary lymphatic pathways.
Diagnosis of insulinoma
The symptoms that appear will form the basis on which the doctor suspects the patient has insulinoma.
Besides checking the patient's symptoms, the doctor will also confirm the diagnosis by conducting a blood test to check blood sugar and insulin levels. The blood test aims to see:
- Hormones that interfere with insulin production
- Drugs that can trigger insulin production from the pancreas
- Protein which inhibits insulin production.
If the results of the blood test lead to insulinoma, the doctor will recommend further tests. In this follow-up examination, the patient will be asked to fast for 48 to 72 hours. The patient will be hospitalized so the doctor can continue to monitor blood sugar levels. The doctor will monitor the patient's sugar and insulin levels every 6 hours. The examination ratio will be evaluated by a doctor and will be the basis for the diagnosis of insulinoma. CT scan or MRI is also used to help doctors determine the location and size of the tumor.
If the tumor cannot be found through both procedures, the diagnosis can be done by endoscopic ultrasound. In this procedure, the doctor will insert a special instrument in the form of a flexible tube long enough in the mouth to reach the patient's stomach and small intestine. This tool will produce and convert sound waves into visual images to see conditions in the stomach, especially the pancreas.
After the location of the tumor is found, the doctor can take a small amount of tumor tissue as a sample. This sample can then be used to determine whether the tumor in the pancreas is cancerous or not.
Treatment and prevention of insulinoma
Surgery is the main step in the treatment of insulinoma. This technique can be done in the form of laparoscopy and open surgery. Laparoscopy is done if only one tumor develops. During laparoscopy, the surgeon will make a small incision in the patient's abdomen and insert a special instrument in the form of a tube with a small camera on the end, which will help the doctor remove the tumor.
At the same time, in insulinomas with several tumors, open surgery is performed to remove the part of the pancreas that attacks the tumor. At a minimum, the pancreas must leave 25% to maintain pancreatic function in the production of digestive food enzymes.
Ten percent of insulinomas are malignant (cancer), so surgical removal of the tumor is not enough to treat it. Additional treatments for treating malignant insulinoma are:
- Cryotherapy - a procedure that uses special fluids to freeze and kill cancer cells.
- Radio frequency ablation - use heat waves that are directly directed against cancer cells to kill them.
- Chemotherapy - treatment of cancer by giving drugs to kill cancer cells.
The following complications related to insulinoma can occur:
- Recurrent insulin insulinoma, especially in patients with more than one tumor
- Pancreatic inflammation and swelling
- Hypoglycemia is getting worse
- Propagation of malignant tumors (cancer) to other parts of the body
- Diabetes
Prevention of insulinoma
Prevention of this disease is not yet known. However, you can make efforts to keep your blood glucose levels within normal limits. These efforts include reducing consumption of red meat, consumption of fruits and vegetables, regular exercise and stopping smoking.
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