Insulinoma Questions & Answers

Updated: May 31, 2020
  • Author: Zonera Ashraf Ali, MBBS; Chief Editor: Neetu Radhakrishnan, MD  more...
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Questions & Answers

Overview

What are insulinomas?

How are insulinomas clinically characterized?

What are symptoms of hypoglycemia in patients with insulinoma?

What causes hypoglycemia in patients with insulinoma?

What is the hallmark of an insulinoma?

How is a biochemical diagnosis of insulinoma established?

Which imaging modalities are used in the diagnosis of insulinomas?

Which medications are used in the treatment of insulinoma?

What are the surgical options for treatment of insulinoma?

What are insulinomas?

What is the pathophysiology of insulinoma?

What are patterns of insulin secretion by insulinomas?

What is the incidence of insulinoma in the US?

What is the global incidence of insulinoma?

What is the mortality and morbidity associated to insulinoma?

What are the racial predilections in the prevalence of insulinoma?

What are the sexual predilections in the prevalence of insulinoma?

Which age groups have the highest incidence of insulinoma?

Presentation

Which clinical history findings are characteristic of insulinoma?

What causes insulinoma?

DDX

How is insulinoma differentiated from other causes of hypoglycemia?

Workup

What is the classic hallmark of insulinomas?

What are the diagnostic criteria for insulinoma?

What is the role of lab testing in the diagnosis of insulinoma?

How is a biochemical diagnosis of insulinoma made?

How is multiple endocrine neoplasia type 1 (MEN 1) assessed during the evaluation for insulinoma?

What is the role of imaging studies in the diagnosis of insulinoma?

What is the role of CT scanning and MRI in the diagnosis of insulinoma?

What is the role of arteriography in the diagnosis of insulinoma?

What is the role of nuclear medicine in the diagnosis of insulinoma?

What is the role of ultrasonography in the diagnosis of insulinoma?

What is the role of portal venous sampling in the evaluation of insulinoma?

What is the role of anti-insulin labeled with iodine-131 in the evaluation of insulinoma?

What is the role of biopsy in the evaluation of insulinoma?

Which histologic findings are characteristic of insulinoma?

How is insulinoma staged?

Treatment

What are the medical treatment options for insulinoma?

What are the medical treatment options for metastatic insulinoma?

How is refractory hypoglycemia treated in patients with insulinoma?

What is the role of ablation in the treatment of insulinoma?

What is the treatment of choice for insulinoma?

What is included in preoperative management of insulinoma?

What are the surgical options for the treatment of insulinoma?

What is the role of surgery in the treatment of metastatic insulinoma?

Which specialist consultations are beneficial for patients with insulinoma?

Which diet and activity modifications are used in the treatment of insulinoma?

Guidelines

Which organizations have issued clinical treatment guidelines for insulinoma?

What are grading schemes for insulinoma?

What are the NCCN guidelines for grading and staging insulinoma?

What the ESMO and NANETS guidelines for grading and staging of insulinoma?

What are the diagnostic guidelines for insulinoma?

What are the guidelines for treatment of insulinoma?

Medications

What is the role of diazoxide in the treatment of insulinoma?

Which medications in the drug class Antineoplastic, mTOr Kinase Inhibitor are used in the treatment of Insulinoma?

Which medications in the drug class Antineoplastic Agents are used in the treatment of Insulinoma?

Which medications in the drug class Radiopharmaceuticals are used in the treatment of Insulinoma?

Which medications in the drug class Somatostatin Analogs are used in the treatment of Insulinoma?

Which medications in the drug class Diuretics are used in the treatment of Insulinoma?

Which medications in the drug class Hyperglycemic agents are used in the treatment of Insulinoma?

Follow-up

What is included in inpatient care for insulinoma?

What are the indications for discontinuation of diazoxide and hydrochlorothiazide in the treatment of insulinoma?

Which specialists should be included in a multidisciplinary treatment team for the management of insulinoma?

What are complications of insulinoma?

What is the prognosis of insulinoma?