Insulinoma

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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