- Main symptoms
- How the diagnosis is made
- Treatment options
- 1. Surgery
- 2. Hormonal medications and insulin regulators
- 3. Chemotherapy
- 4. Ablation and arterial embolization
- Possible causes
Insulinoma, also known as islet cell tumor, is a type of tumor in the pancreas, benign or malignant, that produces excess insulin, causing the blood glucose to decrease, generating hypoglycemia. The symptoms caused by this tumor can be dizziness, mental confusion, tremors and changes in mood and occur due to glucose dysregulation in the bloodstream.
The diagnosis of insulinoma is made by an endocrinologist or oncologist through blood tests, such as fasting glucose and imaging tests, which can be computed tomography, magnetic resonance imaging or pet scan, and the most suitable treatment is surgery, medication hormones and to control blood sugar levels, as well as chemotherapy, ablation or embolization.
Main symptoms
Insulinoma is a type of tumor located in the pancreas that alters blood glucose levels and, therefore, the main symptoms are related to reduced blood sugar, called hypoglycemia, such as:
- Blurred or double vision; Mental confusion; Dizziness; Feeling weak; Excessive irritability; Changes in mood; Fainting; Excessive cold sweat.
In more severe cases, when insulinoma is more advanced and affects other parts of the body, such as the liver, brain and kidneys, symptoms such as seizures, increased heart rate, loss of consciousness, fainting and jaundice may appear. Learn more about jaundice and how to identify it.
How the diagnosis is made
The diagnosis of insulinoma is made through blood tests, which must be performed on an empty stomach, to detect the amount of glucose and insulin in the blood and, generally, glucose values are low and insulin levels are high. See how the fasting blood glucose test is done and the normal reference values.
To find out the exact location, size and type of tumor in the pancreas and to check whether the insulinoma has spread to other parts of the body, imaging tests such as computed tomography, MRI or pet scan are indicated by the endocrinologist or oncologist.
In some situations, the doctor may also order other tests to complement the diagnosis and know the extent of the tumor such as endoscopy, which is used to examine whether the tumor has reached the interior of the stomach or intestine, and arteriography, which identifies the blood flow in the pancreas.
Treatment options
Insulinoma is a type of tumor in the pancreas, which can be benign or malignant, which leads to changes in blood glucose levels, and if it is treated early it can be cured. The treatment for this type of disease is indicated by the oncologist and depends on the location, size and stage of the tumor, as well as on the presence of metastases, and may be recommended:
1. Surgery
Surgery is the most suitable type of treatment for insulinoma, however, if the tumor in the pancreas is very large, has spread to other parts of the body or the person is in poor health, the doctor may not recommend performing a operation. If surgery is performed, the patient may need to use a drain, called a penrose, to eliminate the fluids accumulated during the surgical procedure. See more how to take care of the drain after surgery.
2. Hormonal medications and insulin regulators
Some medications can be used to treat insulinoma, such as drugs that reduce or slow the production of hormones that make the tumor grow, such as somatostatin analogues, called octreotide and lanreotide.
Other medications that are indicated for the treatment of this type of disease are remedies that help to reduce the levels of insulin in the blood, avoiding excessive glucose decrease. And yet, you can eat a high sugar diet so that glucose levels are more normal.
3. Chemotherapy
Chemotherapy is recommended by the oncologist to treat insulinoma with metastasis and consists of the application of drugs in the vein in order to destroy the abnormal cells, which lead to the growth of the tumor, and the number of sessions and the type of drugs to be used depend on characteristics of the disease, such as size and location.
However, the drugs most used to eliminate insulinoma cells are doxorubicin, fluorouracil, temozolomide, cisplatin and etoposide. These remedies are usually administered in the serum, through a catheter in the vein and, in some cases, more than one can be used, depending on the protocol established by the doctor.
4. Ablation and arterial embolization
Radiofrequency ablation is the type of treatment that uses heat, produced by radio waves, to kill sick insulinoma cells and is very suitable for treating small tumors that do not spread to other parts of the body.
As with ablation, arterial embolization is a safe and minimally invasive procedure, recommended by the oncologist to treat small insulinomas and involves the application of specific fluids, through a catheter, to block the flow of blood in the tumor, helping to eliminate the diseased cells.
Possible causes
The exact causes of insulinoma are not yet fully defined, but they tend to develop more in women than men, in people between 40 and 60 years old and who have some genetic disease such as neurofibromatosis type 1 or tuberous sclerosis. Find out more about tuberous sclerosis and how it is treated.
In addition, having other diseases such as endocrine neoplasia, which causes abnormal growth of cells in the endocrine system, and Von Hippel-Lindau syndrome, which is inherited and leads to the appearance of cysts throughout the body, can increase the chances of appearance insulinoma.
