Definition

• Insulinomas are a relatively rare cause of hypoglycemia.

• Endocrine tumors of the pancreas derived from β cells that autonomously secrete insulin
• Insulinomas may be benign (>90%) or malignant (< 10%).
• May be single or multiple tumors
  • More than 99% of insulinomas occur within the pancreas.
    • Distributed equally in the pancreatic head, body, and tail
  • 90% are solitary adenomas, usually small (90% < 2.0 cm).
  • 10% are multiple adenomas, particularly in association with multiple endocrine neoplasia type 1 (MEN-1).
  • 5–15% are metastatic.
  • Nesidioblastosis, or diffuse hyperplasia of the pancreatic islet cells, is rarely seen in adults.

• Insulinomas can occur:
  • As part of the MEN-1 syndrome, in association with pituitary, parathyroid, and other pancreatic islet tumors (i.e., gastrinomas)
    • Less than 10% of insulinomas are associated with MEN-1.
  • As isolated, sporadic tumors without genetic predisposition

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