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1. Ueda J, Nakamura Y, Aimoto T, Hiroi M, Cho K, Yamahatsu K, Kawamoto M, Uchida E: Laparoscopic distal pancreatectomy preserving spleen and splenic vessels for pancreatic insulinoma. J Nippon Med Sch; 2010 Jun;77(3):175-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic distal pancreatectomy preserving spleen and splenic vessels for pancreatic insulinoma.
  • We describe a 43-year-old woman who underwent laparoscopic distal pancreatectomy preserving the spleen and splenic vessels for the treatment of insulinoma in the pancreatic body.
  • The patient experienced cold sweats on fasting, received diagnosis of insulinoma, and was referred to our hospital for laparoscopic surgery.
  • Blood biochemistry studies showed low fasting blood glucose of 42 mg/dL, serial immunoreactive insulin of 15.2 microU/mL, and a Fajans index (immunoreactive insulin/blood glucose) of 0.36 (normal <0.30).
  • Contrast-enhanced early-phase computed tomography of the abdomen showed a circular, intensely stained, 1.6-cm-diameter tumor in the pancreatic body close to the main pancreatic duct.
  • A solitary insulinoma of the pancreatic body was diagnosed on the basis of the result of hematologic studies, and diagnostic imaging results.
  • Because of the location of the tumor, we elected to perform distal pancreatectomy preserving the spleen and splenic vessels, rather than enucleation.
  • Insulin and blood glucose levels were monitored during surgery.
  • Before removal of the tumor, insulin levels remained consistently high, never decreasing to less than 10 microU/mL.
  • After surgery, insulin levels decreased rapidly, to less than 5 microU/mL within 30 minutes and subsequently remained at the new low level, leading us to conclude that the entire tumor had been removed.
  • [MeSH-major] Insulinoma / diagnosis. Insulinoma / surgery. Laparoscopy / methods. Pancreatectomy / methods. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / surgery. Spleen / surgery
  • [MeSH-minor] Adult. Blood Glucose / metabolism. Female. Humans. Insulin / blood. Splenic Artery / surgery. Splenic Vein / surgery. Tomography, X-Ray Computed / methods. Treatment Outcome

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  • (PMID = 20610903.001).
  • [ISSN] 1345-4676
  • [Journal-full-title] Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
  • [ISO-abbreviation] J Nippon Med Sch
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Blood Glucose; 0 / Insulin
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2. Xue HD, Jin ZY, Liu W, Wang Y, Zhao WM: [Perfusion characteristics of normal pancreas and insulinoma on multi-slice spiral CT]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao; 2006 Feb;28(1):68-70
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Perfusion characteristics of normal pancreas and insulinoma on multi-slice spiral CT].
  • OBJECTIVE: To investigate the perfusion characteristics of normal pancreas and insulinoma on multi-slice spiral CT (MSCT).
  • METHODS: Totally 21 subjects with suspected insulinoma were enrolled.
  • Perfusion characteristics, including blood flow (BF), patlak blood volume (pBV), time to peak (TTP), permeability, and peak enhancement (PE) of insulinomas and normal pancreas parenchyma were analyzed based on the MSCT data sets subsequently.
  • RESULTS: Benign insulinoma was pathologically confirmed in 12 out of the 21 subjects, while the remaining 9 subjects were normal.
  • In both normal and tumor-suffered subjects (n = 19), perfusion parameters of normal pancreatic parachyma were measured as follows: BF (p) = 104.
  • In subjects with insulinoma (n = 11), perfusion parameters of tumor tissue were measured as follows: F (i) = 206.5 +/- 42.2, BV (i) = 315.9 +/- 79.0, TFP (i) = 123.2 +/- 18.8, Permeability (i) = 102.5 +/- 54.
  • Results of F, BV, and peak enhancement in these two kinds of tissue showed significant differences (P < 0.01), while there were no significant difference (P > 0.05) in TTP and permeability between normal pancreatic parenchyma and insulinoma.
  • CONCLUSIONS: Benign insulinoma has perfusion characteristics of increased blood flow and blood volume, but its TTP is consistent with normal pancreas and has normal permeability.
  • MSCT allows further understanding of the blood flow of the normal pancreas and its benign tumor insulinoma.
  • [MeSH-major] Insulinoma / radiography. Pancreas / radiography. Pancreatic Neoplasms / radiography. Tomography, Spiral Computed / methods

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  • (PMID = 16548193.001).
  • [ISSN] 1000-503X
  • [Journal-full-title] Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae
  • [ISO-abbreviation] Zhongguo Yi Xue Ke Xue Yuan Xue Bao
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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3. Priego P, Sanjuanbenito A, Martínez Molina E, Lobo E, García Teruel D, Morales V, Rodríguez G, Fresneda V: [Diagnosis and treatment of pancreatic insulinoma]. Rev Esp Enferm Dig; 2007 Apr;99(4):218-22
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  • [Title] [Diagnosis and treatment of pancreatic insulinoma].
  • [Transliterated title] Manejo diagnóstico y terapéutico del insulinoma pancreático.
  • INTRODUCTION: insulinoma is the most frequent pancreatic endocrine tumor.
  • The aim of this study was to evaluate the experience in the management and treatment of this kind of tumor at Hospital Ramón y Cajal.
  • MATERIAL AND METHODS: between January 1999 and July 2006, 12 patients were operated on in our hospital (9 females and 3 males) who had been diagnosed with insulinoma, with a mean age of 56 years (16-72 years).
  • Intraoperative ultrasonography confirmed the presence of an insulinoma in 100% of cases.
  • Two patients developed a pancreatic fistula, and one a pancreatic pseudocyst that healed spontaneously without surgery.
  • However, the initial procedure of choice would be pancreas palpation and intraoperative ultrasonography.
  • Surgery cured 100% of cases, and the procedure selected depends on size, location, distance from the main pancreatic duct, and relation to multiple endocrine neoplasm 1 (MEN-1).
  • [MeSH-major] Insulinoma / diagnosis. Insulinoma / surgery. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / surgery

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  • (PMID = 17590104.001).
  • [ISSN] 1130-0108
  • [Journal-full-title] Revista española de enfermedades digestivas : organo oficial de la Sociedad Española de Patología Digestiva
  • [ISO-abbreviation] Rev Esp Enferm Dig
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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4. Anaye A, Mathieu A, Closset J, Bali MA, Metens T, Matos C: Successful preoperative localization of a small pancreatic insulinoma by diffusion-weighted MRI. JOP; 2009;10(5):528-31
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  • [Title] Successful preoperative localization of a small pancreatic insulinoma by diffusion-weighted MRI.
  • CONTEXT: Insulinoma is the most common functioning endocrine tumor of the pancreas responsible for fasting hypoglycemia resulting from autonomous insulin hypersecretion.
  • Most insulinomas are small and difficult to localize with conventional imaging.
  • We successfully localized a small insulinoma in our patient using diffusion-weighted magnetic resonance imaging before surgery.
  • CASE REPORT: We report the case of a female patient with a clinical suspicion of insulinoma.
  • A preoperative MR with diffusion-weighted imaging was performed and localized a small nodule in the pancreatic tail.
  • Histologic examination identified a neuroendocrine tumor compatible with an insulinoma.
  • CONCLUSION: Diffusion-weighted imaging can be useful in detecting and localizing small insulinomas, especially for those with no hypervascular pattern.
  • [MeSH-major] Diffusion Magnetic Resonance Imaging. Insulinoma / radiography. Pancreatic Neoplasms / radiography

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  • (PMID = 19734630.001).
  • [ISSN] 1590-8577
  • [Journal-full-title] JOP : Journal of the pancreas
  • [ISO-abbreviation] JOP
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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5. Gupta S, McGrath B, Cavener DR: PERK regulates the proliferation and development of insulin-secreting beta-cell tumors in the endocrine pancreas of mice. PLoS One; 2009 Nov 24;4(11):e8008
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  • [Title] PERK regulates the proliferation and development of insulin-secreting beta-cell tumors in the endocrine pancreas of mice.
  • BACKGROUND: PERK eIF2alpha kinase is required for the proliferation of the insulin-secreting beta- cells as well as insulin synthesis and secretion.
  • In addition, PERK signaling has been found to be an important factor in determining growth and angiogenesis of specific types of tumors, and was attributed to PERK-dependent regulation of the hypoxic stress response.
  • In this report we examine the role of PERK in regulating proliferation and angiogenesis of transformed beta-cells in the development of insulinomas.
  • METHODOLOGY: The SV40 Large T-antigen (Tag) was genetically introduced into the insulin secreting beta-cells of Perk KO mice under the control of an inducible promoter.
  • Tumor growth and the related parameters of cell proliferation were measured.
  • In late stage insulinomas the degree of vascularity was determined.
  • PRINCIPAL FINDINGS: The formation and growth of insulinomas in Perk-deficient mice was dramatically ablated with much fewer tumors, which averaged 38-fold smaller than seen in wild-type control mice.
  • Beta-cell proliferation was ablated in Perk-deficient mice associated with reduced tumor growth.
  • In the small number of large encapsulated insulinomas that developed in Perk-deficient mice, we found a dramatic reduction in tumor vascularity compared to similar sized insulinomas in wild-type mice.
  • Although insulinoma growth in Perk-deficient mice was largely impaired, beta-cell mass was increased sufficiently by T-antigen induction to rescue the hypoinsulinemia and diabetes in these mice.
  • CONCLUSIONS: We conclude that PERK has two roles in the development of beta-cell insulinomas, first to support rapid cell proliferation during the initial transition to islet hyperplasia and later to promote angiogenesis during the progression to late-stage encapsulated tumors.

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  • (PMID = 19956728.001).
  • [ISSN] 1932-6203
  • [Journal-full-title] PloS one
  • [ISO-abbreviation] PLoS ONE
  • [Language] ENG
  • [Grant] United States / NIDDK NIH HHS / DK / R01 DK062049; United States / NIGMS NIH HHS / GM / R01 GM056957; United States / NIDDK NIH HHS / DK / R01-DK062049; United States / NIGMS NIH HHS / GM / R01-GM56957
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Viral, Tumor; 0 / Blood Glucose; EC 2.7.10.- / PERK kinase; EC 2.7.11.1 / eIF-2 Kinase
  • [Other-IDs] NLM/ PMC2776514
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6. Berrospi Espinoza F, Celis Zapata J, Ruiz Figueroa E, Chavez Passiuri I, Reaño G: [Localization of pancreatic insulinoma with ultrasonography laparoscopy]. Rev Gastroenterol Peru; 2007 Jan-Mar;27(1):91-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Localization of pancreatic insulinoma with ultrasonography laparoscopy].
  • [Transliterated title] Localización de insulinoma pancreático con ultrasonografía laparoscópica.
  • The case of a 51-year-old woman with a clinical history of hipoglicemia caused by a presumed pancreatic insulinoma is reported.
  • Laboratory tests pointed out for a insulinoma, but imaginologic studies could not locate the tumor.
  • By means of the ultrasonography device the tumor was located at the uncinate process of the pancreas and, eventually treated by laparoscopic enucleation.
  • [MeSH-major] Insulinoma / diagnosis. Laparoscopy / methods. Pancreatic Neoplasms / diagnosis. Ultrasonography, Interventional

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  • (PMID = 17431441.001).
  • [ISSN] 1022-5129
  • [Journal-full-title] Revista de gastroenterología del Perú : órgano oficial de la Sociedad de Gastroenterología del Perú
  • [ISO-abbreviation] Rev Gastroenterol Peru
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Peru
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7. Mai W, Cáceres AV: Dual-phase computed tomographic angiography in three dogs with pancreatic insulinoma. Vet Radiol Ultrasound; 2008 Mar-Apr;49(2):141-8
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  • [Title] Dual-phase computed tomographic angiography in three dogs with pancreatic insulinoma.
  • This article describes the findings in three dogs with histopathologically confirmed pancreatic insulinoma using dual-phase computed tomographic angiography (CTA).
  • In all three dogs, dual-phase CTA findings identified lesions not seen on ultrasonography, including the actual identification of the primary pancreatic neoplasm in two dogs.
  • In two dogs, the insulinomas were found to have a strong enhancement during the arterial phase of the study but not at the other phases, which stresses the importance of dual-phase computed tomography for the diagnosis of this type of pancreatic neoplasia, in agreement with current knowledge in humans.
  • [MeSH-major] Dog Diseases / diagnosis. Insulinoma / veterinary. Pancreatic Neoplasms / veterinary. Tomography, X-Ray Computed

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  • (PMID = 18418994.001).
  • [ISSN] 1058-8183
  • [Journal-full-title] Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association
  • [ISO-abbreviation] Vet Radiol Ultrasound
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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8. Dai MH, Zhao YP, Liao Q, Liu ZW, Hu Y, Guo JC: [Surgical treatment of pancreatic insulinoma by laparoscopy]. Zhonghua Wai Ke Za Zhi; 2006 Feb 1;44(3):165-8
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  • [Title] [Surgical treatment of pancreatic insulinoma by laparoscopy].
  • OBJECTIVE: To evaluate the safety and outcome of laparoscopic insulinoma resection.
  • METHODS: Twenty-five patients with insulinoma were admitted and divided into two groups: laparoscopic group (10 patients) and laparotomy group (15 patients).
  • All tumors of two groups were located at the body or tail of pancreas preoperatively by abdominal CT and digital subtraction angiography (DSA).
  • There were no differences in preoperative location and size of tumors between two groups.
  • However, one case of pancreatic leakage developed in laparoscopic group, comparably, 3 cases of pancreatic leakage, 2 cases of celiac sepsis and 5 cases of fluid accumulation in thoracic cavity developed in laparotomy group.
  • CONCLUSIONS: Laparoscopic resection of pancreatic insulinoma is safe and feasible for tumors located at the body or tail of the pancreas.
  • Its application for tumors located at the pancreatic head needs further evaluation.
  • [MeSH-major] Insulinoma / surgery. Laparoscopy. Pancreatectomy / methods. Pancreatic Neoplasms / surgery

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  • (PMID = 16635344.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] China
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9. Owecki M, Czepczyriński R, Biczysko M, Stawny B, Drews M, Sowiński J: [Usefullness of scintigraphy with somatostatin analogues in the imaging of insulinoma of the pancreas]. Pol Merkur Lekarski; 2006 Jan;20(115):77-80
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  • [Title] [Usefullness of scintigraphy with somatostatin analogues in the imaging of insulinoma of the pancreas].
  • [Transliterated title] Przydatność scyntygrafii z uzyciem analogów somatostatyny w obrazowaniu wyspiaka trzustki typu insulinoma.
  • We present a case of a 74-years-old female with insulinoma of the pancreas.
  • The fast was terminated after 5 hours and 40 minutes because of neuroglycopenic symptoms with the serum glucose and insulin levels of 40 mg/dl and 34,01 microU/ml respectively.
  • The tumor was invisible in ultrasound, abdominal CT scan and MRL The only means that enabled preoperative visualization was 111-Indium labeled octreotide scintigraphy (OctreoScan).
  • Laparotomy was performed, and a tumor was disclosed in intraoperative ultrasonography within the head of the pancreas.
  • The tumor of 37 mm diameter was excised.
  • Histopatological examination revealed benign insulinoma.
  • The patient with proper glucose levels and insulin concentration of 3,04 microU/ml was discharged in good health.
  • This case confirms high usefulness of preoperative OctreoScan and intraoperative ultrasonography in the approach to a patient with insulinoma.
  • [MeSH-major] Indium Radioisotopes. Insulinoma / radionuclide imaging. Pancreatic Neoplasms / radionuclide imaging. Radionuclide Imaging. Somatostatin / analogs & derivatives

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  • (PMID = 16617742.001).
  • [ISSN] 1426-9686
  • [Journal-full-title] Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
  • [ISO-abbreviation] Pol. Merkur. Lekarski
  • [Language] pol
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Indium Radioisotopes; 51110-01-1 / Somatostatin; G083B71P98 / pentetreotide
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10. Ungureanu CD, David L, Braşoveanu V, Herlea V, Coculescu M, Popescu I: [Double localization of pancreatic insulinoma. Diagnostic and therapeutic difficulties]. Chirurgia (Bucur); 2005 Sep-Oct;100(5):489-94
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  • [Title] [Double localization of pancreatic insulinoma. Diagnostic and therapeutic difficulties].
  • [Transliterated title] Insulinom pancreatic cu dublă localizare. Dificultăţi de diagnostic si atitudine terapeutică.
  • Insulinomas are the most common cause of hypoglycemia resulting from endogenous hyperinsulinism.
  • Because most of insulinomas are less than 2 cm in size and rarely they not may be visible by CT scan or transabdominal ultrasonography.
  • We report a case of double insulinoma located in the head of the pancreas in which the diagnosis and surgical treatment presented difficulties which determined a particular clinical evolution.
  • [MeSH-major] Insulinoma / diagnosis. Insulinoma / surgery. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / surgery

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  • (PMID = 16372677.001).
  • [ISSN] 1221-9118
  • [Journal-full-title] Chirurgia (Bucharest, Romania : 1990)
  • [ISO-abbreviation] Chirurgia (Bucur)
  • [Language] rum
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Romania
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11. Kuroki T, Tajima Y, Tsutsumi R, Mishima T, Kitasato A, Adachi T, Kanematsu T: Intraoperative pancreatography and gastric-wall-covering method for the prevention of pancreatic leakage after enucleation of insulinoma in the pancreas. J Hepatobiliary Pancreat Surg; 2006;13(4):314-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intraoperative pancreatography and gastric-wall-covering method for the prevention of pancreatic leakage after enucleation of insulinoma in the pancreas.
  • Pancreatic leakage is one of the most common complications following pancreatic surgery.
  • Although several surgical techniques and several devices for the management of pancreatic ducts have been advocated to prevent pancreatic leakage, its incidence is still not acceptable.
  • We report our new surgical technique, a gastric-wall-covering method, for the prevention of pancreatic leakage in the enucleation of insulinoma in the pancreas, along with intraoperative pancreatography for navigation surgery of the pancreatic duct.
  • Our novel techniques help to prevent pancreatic leakage following pancreatic surgery, including partial resection of the pancreas.
  • [MeSH-major] Digestive System Surgical Procedures / methods. Insulinoma / surgery. Pancreatic Neoplasms / surgery. Postoperative Complications / prevention & control. Stomach / surgery
  • [MeSH-minor] Female. Humans. Intraoperative Period. Middle Aged. Pancreatic Ducts / ultrasonography. Suture Techniques

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  • (PMID = 16858542.001).
  • [ISSN] 0944-1166
  • [Journal-full-title] Journal of hepato-biliary-pancreatic surgery
  • [ISO-abbreviation] J Hepatobiliary Pancreat Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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12. Pugliese R, Boniardi M, Sansonna F, Maggioni D, Scandroglio I, Costanzi A, Rapetti R, Oppizzi G, Loli P: [Video-laparoscopic excision of pancreatic insulinoma. Experience with 3 cases]. Chir Ital; 2008 Jan-Feb;60(1):9-13
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  • [Title] [Video-laparoscopic excision of pancreatic insulinoma. Experience with 3 cases].
  • [Transliterated title] Trattamento chirurgico videolaparoscopico dell'insulinoma pancreatico. Esperienza di tre casi.
  • Laparoscopic treatment of lesions of the distal pancreas has gained favour worldwide in the last decade.
  • The objective of this study was to analyze 3 cases of insulinoma successfully treated with the laparoscopic approach.
  • From 2000 to 2007 in our institution 3 patients with insulinoma of the left pancreas were treated with a laparoscopic approach.
  • The insulinoma was diagnosed by helical CT scan, Two cases were treated by left pancreatectomy and one by enucleation.
  • Morbidity consisted in one mild pancreatic fistula after left pancreatectomy that was healed by conservative treatment after 24 days.
  • During the follow-up insulinoma symptoms have disappeared in all patients.
  • This study confirms the feasibility of laparoscopic resection for insulinoma.
  • [MeSH-major] Insulinoma / surgery. Laparoscopy / methods. Pancreatectomy / methods. Pancreatic Neoplasms / surgery. Video-Assisted Surgery / methods

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  • (PMID = 18389742.001).
  • [ISSN] 0009-4773
  • [Journal-full-title] Chirurgia italiana
  • [ISO-abbreviation] Chir Ital
  • [Language] ita
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Blood Glucose
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13. Aoki T, Hui H, Umehara Y, Licalzi S, Demetriou AA, Rozga J, Perfetti R: Intrasplenic Transplantation of Encapsulated Genetically Engineered Mouse Insulinoma Cells Reverses Streptozotocin-Induced Diabetes in Rats. Cell Transplant; 2005 Jul;14(6):411-421

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intrasplenic Transplantation of Encapsulated Genetically Engineered Mouse Insulinoma Cells Reverses Streptozotocin-Induced Diabetes in Rats.
  • Pancreatic islet transplantation is limited by shortage of donor organs.
  • Although β-cell lines could be used, their secretion of insulin is characteristically glucose independent and immunoisolation is required.
  • Here we show that intrasplenic transplantation of encapsulated glucose-responsive mouse insulinoma cells reversed streptozotocin (STZ)-induced diabetes in rats.
  • MIN-6 cells derived from a transgenic mouse expressing SV 40 large T antigen in pancreatic β-cells were transfected with minigene encoding for human glucagon-like-peptide-1 under the control of rat insulin promoter.
  • The cells were encapsulated in alginate/poly-L-lysine and used for cell transplantation in STZ-diabetic rats.
  • In group I rats (n = 6) 20 million encapsulated cells were injected into the spleen.
  • Plasma insulin level was measured every other week (RIA).
  • In rats transplanted with cells the n-FBG was 100-150 mg/dl until the end of the study.
  • After splenectomy, all cell recipients became diabetic (glucose 400 ± 20 mg/dl).
  • Transplanted rats showed increase in body weight and insulin production (3.3 ± 1.0 ng/ml versus 0.92 ± 0.3 ng/ml; p < 0.01) and had normal IPGTT.
  • Spleens contained capsules with insulin-positive cells.
  • Overall, data from this work indicate that intrasplenic transplantation of xenogeneic encapsulated insulin-producing cells without immunosuppression reversed diabetes in rats.
  • Excellent survival and function of the transplanted cells was due to the fact that the cells were separated from the bloodstream by the immunoisolatory membrane only and insulin was delivered directly to the liver (i.e., in a physiological manner).

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  • (PMID = 28876105.001).
  • [ISSN] 1555-3892
  • [Journal-full-title] Cell transplantation
  • [ISO-abbreviation] Cell Transplant
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Keywords] NOTNLM ; Diabetes / Encapsulation / Insulin / Insulinoma cells / Pancreatic islets / Streptozotocin / Transplantation technique
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14. Morita S, Machida H, Kuwatsuru R, Saito N, Suzuki K, Iihara M, Obara T, Mitsuhashi N: Preoperative localization of pancreatic insulinoma by super selective arterial stimulation with venous sampling. Abdom Imaging; 2007 Jan-Feb;32(1):126-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Preoperative localization of pancreatic insulinoma by super selective arterial stimulation with venous sampling.
  • Although most insulinomas are small, they have been successfully detected by computed tomography and magnetic resonance imaging recently.
  • However, preoperative localization of the insulinomas by arterial stimulation with venous sampling is crucial when they show atypical findings on these imaging modalities.
  • We report a case of a large benign insulinoma located at the pancreatic tail; this tumor was diagnosed correctly by super selective arterial stimulation with venous sampling.
  • [MeSH-major] Calcium. Insulin / blood. Insulinoma / diagnosis. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Aged. Angiography / methods. Contrast Media. Humans. Injections, Intra-Arterial. Magnetic Resonance Imaging. Male. Pancreas / blood supply. Preoperative Care. Splenic Artery / radiography. Tomography, X-Ray Computed

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  • (PMID = 16932851.001).
  • [ISSN] 0942-8925
  • [Journal-full-title] Abdominal imaging
  • [ISO-abbreviation] Abdom Imaging
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media; 0 / Insulin; SY7Q814VUP / Calcium
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15. Tomita T, Masuzaki H, Noguchi M, Iwakura H, Fujikura J, Tanaka T, Ebihara K, Kawamura J, Komoto I, Kawaguchi Y, Fujimoto K, Doi R, Shimada Y, Hosoda K, Imamura M, Nakao K: GPR40 gene expression in human pancreas and insulinoma. Biochem Biophys Res Commun; 2005 Dec 30;338(4):1788-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] GPR40 gene expression in human pancreas and insulinoma.
  • To assess gene expression of a membrane-bound G-protein-coupled fatty acid receptor, GPR40, in the human pancreas and islet cell tumors obtained at surgery were analyzed.
  • The mRNA level of the GPR40 gene in isolated pancreatic islets was approximately 20-fold higher than that in the pancreas, and the level was comparable to or rather higher than that of the sulfonylurea receptor 1 gene, which is known to be expressed abundantly in human pancreatic beta cells.
  • A large amount of GPR40 mRNA was detected in tissue extracts from two cases of insulinoma, whereas the expression was undetectable in glucagonoma or gastrinoma.
  • The present study demonstrates that GPR40 mRNA is expressed predominantly in pancreatic islets in humans and that GPR40 mRNA is expressed solely in human insulinoma among islet cell tumors.
  • These results indicate that GPR40 is probably expressed in pancreatic beta cells in the human pancreas.
  • [MeSH-major] Insulinoma / metabolism. Pancreas / metabolism. Pancreatic Neoplasms / metabolism. Receptors, G-Protein-Coupled / biosynthesis

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  • (PMID = 16289108.001).
  • [ISSN] 0006-291X
  • [Journal-full-title] Biochemical and biophysical research communications
  • [ISO-abbreviation] Biochem. Biophys. Res. Commun.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / FFAR1 protein, human; 0 / RNA, Messenger; 0 / Receptors, G-Protein-Coupled
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16. Akca A, Mann K, Starke A, Lammers BJ, Goretzki PE: [Insulinoma associated with pregnancy]. Dtsch Med Wochenschr; 2010 Jul;135(30):1484-6
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  • [Title] [Insulinoma associated with pregnancy].
  • [Transliterated title] Postpartales Insulinom.
  • INVESTIGATION AND DIAGNOSIS: The following examination showed a low basal blood glucose level as well as pathological levels of insulin and C-peptide.
  • These findings together with the Whipple trias (hypoglycaemia, neurological symptoms and rapid improvement after infusion of glucose) were highly suspicious of an insulinoma.
  • Whereas CT, MRI and DOTATOC-PET were negative, endoscopic ultrasound showed a mass of 13 mm in the tail of the pancreas.
  • TREATMENT AND COURSE: The tumour was resected from the tail of the pancreas by laparoscopic enucleation.
  • Histological examination revealed an endocrine tumour (insulinoma) of the pancreas.
  • CONCLUSION: Despite its rarity, an insulinoma represents an important differential diagnosis of hypoglycaemia during and right after pregnancy.
  • [MeSH-major] Insulinoma / diagnosis. Insulinoma / surgery. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / surgery. Pregnancy Complications, Neoplastic / diagnosis. Pregnancy Complications, Neoplastic / surgery

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  • [Copyright] Georg Thieme Verlag KG Stuttgart, New York.
  • (PMID = 20648406.001).
  • [ISSN] 1439-4413
  • [Journal-full-title] Deutsche medizinische Wochenschrift (1946)
  • [ISO-abbreviation] Dtsch. Med. Wochenschr.
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
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17. Gómez-Pérez FJ, Cuevas-Ramos D, Valdés PA, Aguilar-Salinas CA, Mehta R, Rull JA: Beta-cell adenomas without hyperinsulinemia with use of highly specific insulin radioimmunoassays: case report and review of literature. Endocr Pract; 2010 Jul-Aug;16(4):660-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Beta-cell adenomas without hyperinsulinemia with use of highly specific insulin radioimmunoassays: case report and review of literature.
  • OBJECTIVE: To report a case of a proinsulin-secreting islet cell adenoma in which the diagnosis was obscured by an ultraspecific insulin assay.
  • METHODS: We describe the case of a 46-year-old woman, who presented with fasting hypoglycemia and appropriately low insulin values.
  • During the entire fasting test, highly specific insulin remained at <3 mIU/L, with a median value (and interquartile range) of 0.9 (0.8 to 2.3) mIU/L, when the glucose concentration was <50 mg/dL.
  • Magnetic resonance imaging and endoscopic ultrasonography confirmed the presence of a 2.5-cm tumor in the head of the pancreas.
  • A proinsulin-secreting islet cell tumor was diagnosed.
  • Surgical resection of the tumor was successfully accomplished, but diabetes mellitus developed 4 months postoperatively.
  • CONCLUSION: The diagnosis of a hypoglycemia-producing pancreatic adenoma can be missed when an ultraspecific insulin assay is used.
  • [MeSH-major] Insulinoma / blood. Insulinoma / diagnosis. Pancreatic Neoplasms / blood. Pancreatic Neoplasms / diagnosis. Proinsulin / blood
  • [MeSH-minor] Diagnosis, Differential. Endosonography. Female. Humans. Hypoglycemia / blood. Insulin / blood. Magnetic Resonance Imaging. Middle Aged. Radioimmunoassay

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  • (PMID = 20439243.001).
  • [ISSN] 1934-2403
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Insulin; 9035-68-1 / Proinsulin
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18. Kutsuna N, Yamazaki S, Itoh Y, Wakabayashi K, Iwama A, Watanabe Y, Haraguchi Y, Ueda T, Takayama T: Arterial stimulation and venous sampling (ASVS) is useful for recurrent lesions of insulinoma: a case report. Surg Laparosc Endosc Percutan Tech; 2009 Aug;19(4):e138-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Arterial stimulation and venous sampling (ASVS) is useful for recurrent lesions of insulinoma: a case report.
  • We encountered a recurrent case of benign solitary insulinoma in the pancreatic tail, which may have been caused by an inadequate surgical margin in the use of an ultrasonic dissector.
  • A 45-year-old man was referred with hypoglycemia and diagnosed solitary insulinoma in the pancreas.
  • Laparoscopic pancreatic enucleation was performed using an ultrasonic dissector.
  • The tumor was extracted and the surgical margins were microscopically negative.
  • He underwent resection of all visible lesions with omentum and wide excision of the soft tissue surrounding the pancreas after preoperative arterial stimulation and venous sampling test.
  • [MeSH-major] Calcium Gluconate / administration & dosage. Gastrointestinal Agents / administration & dosage. Insulin / blood. Insulinoma / blood. Pancreatic Neoplasms / blood

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  • (PMID = 19692865.001).
  • [ISSN] 1534-4908
  • [Journal-full-title] Surgical laparoscopy, endoscopy & percutaneous techniques
  • [ISO-abbreviation] Surg Laparosc Endosc Percutan Tech
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Gastrointestinal Agents; 0 / Insulin; SQE6VB453K / Calcium Gluconate
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19. Limmer S, Huppert PE, Juette V, Lenhart A, Welte M, Wietholtz H: Radiofrequency ablation of solitary pancreatic insulinoma in a patient with episodes of severe hypoglycemia. Eur J Gastroenterol Hepatol; 2009 Sep;21(9):1097-101
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Radiofrequency ablation of solitary pancreatic insulinoma in a patient with episodes of severe hypoglycemia.
  • Insulinomas are rare neuroendocrine tumors of the pancreas.
  • In this case, we describe the successful use of computed tomography (CT)-guided radiofrequency ablation (RFA) of an insulinoma in an 80-year-old female patient.
  • An insulinoma measuring 1.5 cm in diameter was localized by endoscopic ultrasound and CT scan in the tail of the pancreas.
  • Owing to a high surgical risk caused by the patient's comorbidities and poor physical condition, the resection of the tumor was not considered.
  • Using CT-guided percutaneous RFA, the insulinoma was successfully ablated.
  • A control-CT, 5 weeks after RFA, revealed no residual tumor.
  • In conclusion, we found RFA suitable for the treatment of pancreatic insulinomas.
  • [MeSH-major] Catheter Ablation. Hypoglycemia / etiology. Insulinoma / surgery. Pancreatic Neoplasms / surgery

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  • (PMID = 19685572.001).
  • [ISSN] 1473-5687
  • [Journal-full-title] European journal of gastroenterology & hepatology
  • [ISO-abbreviation] Eur J Gastroenterol Hepatol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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20. Iseri T, Yamada K, Chijiwa K, Nishimura R, Matsunaga S, Fujiwara R, Sasaki N: Dynamic computed tomography of the pancreas in normal dogs and in a dog with pancreatic insulinoma. Vet Radiol Ultrasound; 2007 Jul-Aug;48(4):328-31
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  • [Title] Dynamic computed tomography of the pancreas in normal dogs and in a dog with pancreatic insulinoma.
  • To establish optimal imaging conditions for enhanced computed tomography (CT) for canine pancreatic tumors, 10 healthy beagles were subjected to dynamic CT.
  • This technique was then applied to a dog with suspected insulinoma.
  • The changes in mean peak enhancement and the delay time of the aorta and pancreas were determined.
  • In normal beagles, maximal arterial and pancreatic CT enhancement was observed at 15 +/- 2 s (795 +/- 52 Housfield unit [HU]) and 28 +/- 9 s (118 +/- 16HU) after contrast medium injection, respectively.
  • Multiphase enhanced CT was performed in a pug with suspected insulinoma using the CT protocol defined for the normal beagles with some parameters modified; the images were acquired at the arterial (14 s after contrast medium injection), pancreatic (after 28 s), and equilibrium (after 90 s) phases; scanning was followed by exploratory laparotomy.
  • CT images were characterized by an enhanced mass in the left pancreatic lobe at the arterial phase, during which the difference between the CT values of the mass and normal pancreas was the highest.
  • Histopathologic diagnosis of the pancreatic mass was insulinoma.
  • Thus, it appears that enhanced CT imaging can be used to delineate the pancreas from a pancreatic mass, and it may be helpful in deciding the need for surgery.
  • [MeSH-major] Dog Diseases / diagnosis. Dogs / anatomy & histology. Insulinoma / veterinary. Pancreas / anatomy & histology. Pancreatic Neoplasms / veterinary. Tomography, X-Ray Computed / veterinary

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  • (PMID = 17691631.001).
  • [ISSN] 1058-8183
  • [Journal-full-title] Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association
  • [ISO-abbreviation] Vet Radiol Ultrasound
  • [Language] eng
  • [Publication-type] Case Reports; Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media
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21. Berrospi Espinoza F, Ruiz Figueroa E, Chavez Passiuri I, Celis Zapata J: [Laparoscopic treatment of insulinoma: surgical technique and perisurgical results]. Rev Gastroenterol Peru; 2005 Oct-Dec;25(4):366-70
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Laparoscopic treatment of insulinoma: surgical technique and perisurgical results].
  • [Transliterated title] Tratamiento laparoscópico del Insulinoma pancreático. Técnica quirúrgica y resultados peri operatorios.
  • AIM: Our experience with the laparoscopic treatment of pancreatic insulinomas is reported.
  • PATIENTS AND METHODS: Four patients with clinical and radiological diagnosis of insulinoma were treated between January 2000 and September 2005.
  • RESULTS: All the patients were laparoscopically approached to attempt the tumor enucleation.
  • In three cases complete enucleation was possible; the remaining case was converted to perform the resection of the middle portion of the pancreas.
  • One patient developed a pancreatic fistula that closed spontaneously.
  • In all cases histological evaluation of the tumor showed benign islet cell tumor.
  • CONCLUSION: Laparoscopic enucleation of pancreatic insulinoma is a feasible and safe technique.
  • [MeSH-major] Insulinoma / surgery. Laparoscopy / methods. Pancreatic Neoplasms / surgery

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  • (PMID = 16333393.001).
  • [ISSN] 1022-5129
  • [Journal-full-title] Revista de gastroenterología del Perú : órgano oficial de la Sociedad de Gastroenterología del Perú
  • [ISO-abbreviation] Rev Gastroenterol Peru
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Peru
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22. Andronesi D, Andronesi A, Tonea A, Andrei S, Herlea V, Lupescu I, Ionescu-Târgovişte C, Coculescu M, Fica S, Ionescu M, Gheorghe C, Popescu I: [Insulinoma of the pancreas: analysis of a clinical series of 30 cases]. Chirurgia (Bucur); 2009 Nov-Dec;104(6):675-85
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Insulinoma of the pancreas: analysis of a clinical series of 30 cases].
  • [Transliterated title] Insulinomul pancreatic--analiza unei serii clinice de 30 de cazuri.
  • Insulinoma is the most frequent neuroendocrine pancreatic tumor and is the main cause for hypoglicemia due to endogenous hyperinsulinism.
  • We performed an analysis of a clinical series in order to study the clinical and biological spectrum of presentation, the preoperatory imagistic diagnosis and results of the surgical approach.
  • Between 1986-2009, 30 patients with symptoms suggesting an insulinoma were hospitalized in our department.
  • Preoperatory localization of insulinomas was possible in 16 patients.
  • Intraoperatory ultrasound was performed in 16 patients and its sensitivity in detection of insulinomas was 93%; the combination between intraoperative ultrasound and manual exploration of pancreas by the surgeon reached a 100% sensitivity.
  • Before the intraoperatory ultrasound was used the tumor excision was predominantly done by extensive pancreatic resection, while after this was available in our centre more conservative (enucleo-resection) procedures were chosen.
  • The dimensions of the tumor were less than 2 cm in most of the patients; 2 had nesidioblastosis and 2 had multiple insulinomas; all 28 patients proved to have benign insulinomas at histological specimens.
  • The most common complication following extensive pancreatic resections was acute pancreatitis, while after enucleation pancreatic fistula occurred more frequently.
  • CONCLUSIONS: Due to small dimensions, the preoperative diagnosis of insulinomas is usually difficult, ecoendoscopy being the most sensitive method.
  • Intraoperative ultrasound is essential for insulinoma localization and for chosing the optimal type of excision.
  • In benign insulinomas the prognosis is excellent, surgical resection being curative in all cases.
  • [MeSH-major] Insulinoma / surgery. Insulinoma / ultrasonography. Pancreatectomy / methods. Pancreatic Neoplasms / surgery. Pancreatic Neoplasms / ultrasonography. Ultrasonography, Interventional
  • [MeSH-minor] Adult. Aged. Female. Humans. Laparoscopy / adverse effects. Magnetic Resonance Imaging. Male. Middle Aged. Pancreatic Fistula / etiology. Pancreatitis / etiology. Retrospective Studies. Robotics. Sensitivity and Specificity. Treatment Outcome

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  • (PMID = 20187465.001).
  • [ISSN] 1221-9118
  • [Journal-full-title] Chirurgia (Bucharest, Romania : 1990)
  • [ISO-abbreviation] Chirurgia (Bucur)
  • [Language] rum
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Romania
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23. Xian X, Håkansson J, Ståhlberg A, Lindblom P, Betsholtz C, Gerhardt H, Semb H: Pericytes limit tumor cell metastasis. J Clin Invest; 2006 Mar;116(3):642-51
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  • [Title] Pericytes limit tumor cell metastasis.
  • Previously we observed that neural cell adhesion molecule (NCAM) deficiency in beta tumor cells facilitates metastasis into distant organs and local lymph nodes.
  • Here, we show that NCAM-deficient beta cell tumors grew leaky blood vessels with perturbed pericyte-endothelial cell-cell interactions and deficient perivascular deposition of ECM components.
  • Conversely, tumor cell expression of NCAM in a fibrosarcoma model (T241) improved pericyte recruitment and increased perivascular deposition of ECM molecules.
  • Together, these findings suggest that NCAM may limit tumor cell metastasis by stabilizing the microvessel wall.
  • To directly address whether pericyte dysfunction increases the metastatic potential of solid tumors, we studied beta cell tumorigenesis in primary pericyte-deficient Pdgfb(ret/ret) mice.
  • This resulted in beta tumor cell metastases in distant organs and local lymph nodes, demonstrating a role for pericytes in limiting tumor cell metastasis.
  • These data support a new model for how tumor cells trigger metastasis by perturbing pericyte-endothelial cell-cell interactions.
  • [MeSH-major] Adenoma, Islet Cell / pathology. Neoplasm Metastasis / pathology. Neoplasm Metastasis / prevention & control. Pancreatic Neoplasms / pathology. Pericytes / physiology
  • [MeSH-minor] Animals. Cell Communication / genetics. Endothelium, Vascular / metabolism. Endothelium, Vascular / pathology. Fibrosarcoma / blood supply. Fibrosarcoma / genetics. Fibrosarcoma / metabolism. Fibrosarcoma / pathology. Mice. Mice, Inbred C57BL. Mice, Knockout. Neovascularization, Pathologic / metabolism. Neural Cell Adhesion Molecules / deficiency. Neural Cell Adhesion Molecules / genetics. Neural Cell Adhesion Molecules / physiology

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  • (PMID = 16470244.001).
  • [ISSN] 0021-9738
  • [Journal-full-title] The Journal of clinical investigation
  • [ISO-abbreviation] J. Clin. Invest.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Neural Cell Adhesion Molecules
  • [Other-IDs] NLM/ PMC1361347
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24. Rott G, Biggemann M, Pfohl M: Embolization of an insulinoma of the pancreas with trisacryl gelatin microspheres as definitive treatment. Cardiovasc Intervent Radiol; 2008 May-Jun;31(3):659-62
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  • [Title] Embolization of an insulinoma of the pancreas with trisacryl gelatin microspheres as definitive treatment.
  • Insulinomas are rare, mostly benign neuroendocrine tumors, originating in 99% of cases from the pancreas, that synthesize and secrete insulin, causing symptomatic hypoglycemia.
  • We present the case of an 84-year-old woman with a symptomatic insulinoma who refused surgery and was treated with arterial embolization using trisacryl gelatin microspheres as definitive treatment.
  • [MeSH-major] Acrylic Resins / administration & dosage. Embolization, Therapeutic / methods. Gelatin / administration & dosage. Insulinoma / therapy. Pancreatic Neoplasms / therapy

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  • (PMID = 17922161.001).
  • [ISSN] 1432-086X
  • [Journal-full-title] Cardiovascular and interventional radiology
  • [ISO-abbreviation] Cardiovasc Intervent Radiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Acrylic Resins; 0 / trisacryl gelatin microspheres; 9000-70-8 / Gelatin
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25. Winer JH, Choi HS, Gibbs-Strauss SL, Ashitate Y, Colson YL, Frangioni JV: Intraoperative localization of insulinoma and normal pancreas using invisible near-infrared fluorescent light. Ann Surg Oncol; 2010 Apr;17(4):1094-100
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  • [Title] Intraoperative localization of insulinoma and normal pancreas using invisible near-infrared fluorescent light.
  • BACKGROUND: Neuroendocrine tumors of the pancreas, such as insulinoma, are difficult to localize, and complete resection is essential for cure.
  • Our hypothesis is that a near-infrared (NIR) fluorophore exhibiting uptake in insulinoma could provide high-sensitivity detection intraoperatively.
  • MB was injected as a rapid intravenous bolus at doses ranging from 0.25 to 2 mg/kg into wildtype rats and pigs, and into insulinoma-bearing transgenic mice.
  • The signal-to-background ratios (SBR) of tissues and tumors were quantified using FLARE software.
  • At doses > or =1 mg/kg, certain normal tissues, such as pancreas, accumulate MB and remain NIR fluorescent for up to 1 h with an SBR > or = 1.6.
  • Interestingly, insulinoma exhibits even higher MB signal than normal pancreas, resulting in insulinoma-to-pancreas ratios of 3.7 and insulinoma-to-muscle ratios of 16.2.
  • MB permitted high-sensitivity, real-time localization of primary, multicentric, and metastatic insulinoma and permitted differentiation among tumor, normal pancreas, and other abdominal structures.
  • CONCLUSION: A single intravenous injection of a clinically available, commonly used NIR fluorophore provides prolonged intraoperative localization of normal pancreas and insulinoma using invisible NIR fluorescent light.

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  • (PMID = 20033320.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA115296-03; United States / NCI NIH HHS / CA / R01 CA115296; United States / NCI NIH HHS / CA / R01 CA115296-03; United States / NCI NIH HHS / CA / R01-CA-115296
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Fluorescent Dyes; T42P99266K / Methylene Blue
  • [Other-IDs] NLM/ NIHMS158806; NLM/ PMC2841719
  • [Keywords] NOTNLM ; Intraoperative Imaging / Methylene Blue / Near-Infrared Fluorescence / Neuroendocrine Tumors / Pancreas
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26. Pakhetra R, Priya G, Jyotsna VP, Seith A, Ammini AC: Insulinoma: reversal of brain magnetic resonance imaging changes following resection. Neurol India; 2008 Apr-Jun;56(2):192-4
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  • [Title] Insulinoma: reversal of brain magnetic resonance imaging changes following resection.
  • Insulinoma presents with myriad manifestations and severe neurological deficit may develop due to delay in diagnosis.
  • There was complete reversal of neurological deficit and brain magnetic resonance imaging changes of hypoglycemia on follow-up after resection of pancreatic insulinoma.
  • This is the first report which shows reversal of hypoglycemic changes in MRI after resection of insulinoma.
  • Insulinoma, pre and post surgery provides a model for study of the effect of hypoglycemia and its improvement after euglycemia.
  • [MeSH-major] Brain / pathology. Insulinoma / pathology. Magnetic Resonance Imaging / methods
  • [MeSH-minor] Adult. Female. Humans. Pancreatic Neoplasms / pathology. Pancreatic Neoplasms / surgery

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  • (PMID = 18688148.001).
  • [ISSN] 0028-3886
  • [Journal-full-title] Neurology India
  • [ISO-abbreviation] Neurol India
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] India
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27. Bonfig W, Kann P, Rothmund M, Schwarz HP: Recurrent hypoglycemic seizures and obesity: delayed diagnosis of an insulinoma in a 15 year-old boy--final diagnostic localization with endosonography. J Pediatr Endocrinol Metab; 2007 Sep;20(9):1035-8
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  • [Title] Recurrent hypoglycemic seizures and obesity: delayed diagnosis of an insulinoma in a 15 year-old boy--final diagnostic localization with endosonography.
  • Insulinoma in children and adolescents is extremely rare.
  • We present a case of insulinoma with onset of symptoms at the age of 12.5 years.
  • Diagnosis was made very soon after the first symptoms, but diagnostic localization was delayed, since conventional MRI did not reveal the insulinoma.
  • A solitary insulinoma in the pancreatic tail was enucleated laparoscopically.
  • [MeSH-major] Hypoglycemia / physiopathology. Insulinoma / ultrasonography. Obesity / physiopathology. Pancreatic Neoplasms / ultrasonography. Seizures / physiopathology


28. Miron A, Calu V, Giulea C, Fica S, Barbu C, Stefan C: Laparoscopically treated pancreatic insulinoma. Case report. J Med Life; 2010 Apr-Jun;3(2):186-90
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  • [Title] Laparoscopically treated pancreatic insulinoma. Case report.
  • Usually, insulinomas are small sized, insulin secreting, benign tumors of the pancreas, and require surgical treatment.
  • We report the case of a female patient, of 61 years old, with pancreatic insulinoma localized in the junction between the head and the istm of the pancreas, of 1,4 cm in size, which induced hypoglycemia due to endogenous insulin hypersecretion.
  • The tumor was removed by laparoscopic enucleation in March 2009.
  • [MeSH-major] Insulinoma / surgery. Pancreatic Neoplasms / surgery

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  • (PMID = 20968207.001).
  • [ISSN] 1844-122X
  • [Journal-full-title] Journal of medicine and life
  • [ISO-abbreviation] J Med Life
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Romania
  • [Chemical-registry-number] 0 / Blood Glucose
  • [Other-IDs] NLM/ PMC3019046
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29. Horino T, Takao T, Hashimoto K: A case with insulinoma diagnosed and localized preoperatively using contrast-enhanced ultrasonography (CEUS) and arterial stimulation and venous sampling (ASVS). Endocr J; 2006 Feb;53(1):141-6
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  • [Title] A case with insulinoma diagnosed and localized preoperatively using contrast-enhanced ultrasonography (CEUS) and arterial stimulation and venous sampling (ASVS).
  • We report a case with insulinoma diagnosed and localized preoperatively using a combination of contrast-enhanced ultrasonography (CEUS) and arterial stimulation and venous sampling (ASVS).
  • Fajans' ratio, Grunt's ratio, and Turner's ratio, which are reported to be indexes for endogenous hyperinsulinemia in insulinoma, were all negative.
  • CEUS showed a small low echoic lesion in the pancreatic body with blood flow and ASVS showed that the insulin levels in the hepatic vein were extremely increased by calcium injection to the splenic artery, indicating an insulinoma in the pancreatic body preoperatively.
  • An open intra-abdominal operation was performed and an insulinoma was confirmed in the pancreatic body.
  • Enucleation of tumor was undertaken and symptomatic hypoglycemia improved.
  • [MeSH-major] Angiography / methods. Insulinoma / blood supply. Insulinoma / ultrasonography. Pancreatic Neoplasms / blood supply. Pancreatic Neoplasms / ultrasonography. Ultrasonography / methods

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  • (PMID = 16543684.001).
  • [ISSN] 0918-8959
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] SY7Q814VUP / Calcium
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30. Sotoudehmanesh R, Hedayat A, Shirazian N, Shahraeeni S, Ainechi S, Zeinali F, Kolahdoozan S: Endoscopic ultrasonography (EUS) in the localization of insulinoma. Endocrine; 2007 Jun;31(3):238-41
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  • [Title] Endoscopic ultrasonography (EUS) in the localization of insulinoma.
  • OBJECTIVE: Endoscopic ultrasonography has been accepted as a sensitive modality for preoperative tumor localization in pancreas.
  • We have aimed to determine the performance characteristics of endoscopic ultrasonography in pancreatic insulinoma localization and evaluation of relationship between the tumor size and serum-c peptide level, lowest glucose level and insulin level.
  • METHODS: Patients suspicious to insulinoma according to clinical and laboratory findings were included.
  • Endoscopic ultrasonography was performed and if a tumor was identified, the patient was referred for surgery.
  • In one patient, a tumor was identified both by transabdominal ultrasonography and abdominal CT scan.
  • The overall sensitivity and accuracy of endoscopic ultrasonography for detection of insulinoma was 89.5% and 83.7% respectively.
  • The sensitivity of endoscopic ultrasonography for detection of lesions in pancreatic head, body and tail was 92.6%, 78.9%, and 40.0%, respectively.
  • There was no relationship between c-peptide, lowest blood glucose, insulin blood levels and tumor size in surgery.
  • CONCLUSION: EUS is an accurate method for detection of insulinoma.
  • The accuracy depends on the location of the tumor and is greatest for tumors in the pancreatic head.
  • [MeSH-major] Endosonography / methods. Insulinoma / diagnostic imaging. Pancreatic Neoplasms / diagnostic imaging
  • [MeSH-minor] Adolescent. Adult. Aged. Blood Glucose / metabolism. C-Peptide / blood. Female. Humans. Insulin / blood. Male. Middle Aged. Neoplasm Staging. Pancreatectomy. Sensitivity and Specificity. Ultrasonography, Interventional / methods

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  • (PMID = 17906369.001).
  • [ISSN] 1355-008X
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Blood Glucose; 0 / C-Peptide; 0 / Insulin
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31. Bachmann J, Kleeff J, Bergmann F, Shrikhande SV, Hartschuh W, Büchler MW, Friess H: Pancreatic metastasis of Merkel cell carcinoma and concomitant insulinoma: case report and literature review. World J Surg Oncol; 2005 Sep 1;3:58

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  • [Title] Pancreatic metastasis of Merkel cell carcinoma and concomitant insulinoma: case report and literature review.
  • BACKGROUND: Merkel cell carcinomas are rare neoplasm of neuroendocrine origin, usually observed in elderly people in areas with abundant sunlight, and predominantly located on the head and neck, extremities, and trunk.
  • In many patients, a local recurrence after resection of the primary tumour and even distant metastases can be found.
  • CASE PRESENTATION: We report an unusual occurrence of pancreatic metastases from a previously diagnosed Merkel cell carcinoma with the discovery of a concomitant insulinoma.
  • An 82-year old lady suffered from recurrent attacks of hypoglycemia and presented with an abdominal mass, 2 years prior she had an excision done on her eyebrow that was reported as Merkel cell carcinoma.
  • Final histopathology of the mass was a poorly differentiated endocrine carcinoma in the pancreatic tail, in the peripancreatic tissue and in the surrounding soft tissue consistent with metastatic Merkel cell carcinoma in addition to an insulinoma of the pancreatic body.
  • CONCLUSION: This is the first documented case of a metastatic Merkel cell carcinoma and a concomitant insulinoma, suggesting either a mere coincidence or an unknown neuroendocrine tumor syndrome.

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  • (PMID = 16137328.001).
  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1208966
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32. Cazabat L, Chanson P: [Hypoglycemia and insulinoma]. Ann Endocrinol (Paris); 2009 Sep;70 Suppl 1:S2-11
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  • [Title] [Hypoglycemia and insulinoma].
  • [Transliterated title] Hypoglycémie et insulinome.
  • Insulinomas are rare causes of hypoglycemia.
  • A mixed-meal test may also help to diagnose the very rare cases of postprandial hypoglycemia related to non insulinoma pancreatogenic hypoglycemic syndrome (NIPHS) or to some rare insulinomas.
  • Only when diagnosis of hypoglycemic hyperinsulinism is made, the tumor localization process may be initiated.
  • This may be difficult due to the small size of insulinomas (generally < 1 cm).
  • First results with a very new technique, the GLP-1 receptor imaging, are promising for localizing very small tumors.
  • This localization aims to allow a sparing surgery; enucleation of benign tumors, if possible, allows a pancreatic tissue preservation in patients with quite normal survival.
  • [MeSH-major] Hypoglycemia / etiology. Insulinoma / complications. Pancreatic Neoplasms / complications

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  • (PMID = 19878764.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 82
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33. Tao P, Xu D, Lin S, Ouyang GL, Chang Y, Chen Q, Yuan Y, Zhuo X, Luo Q, Li J, Li B, Ruan L, Li Q, Li Z: Abnormal expression, highly efficient detection and novel truncations of midkine in human tumors, cancers and cell lines. Cancer Lett; 2007 Aug 8;253(1):60-7
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  • [Title] Abnormal expression, highly efficient detection and novel truncations of midkine in human tumors, cancers and cell lines.
  • We detected aberrant Midkine (MK) expressions in human insulinoma and pancreatic cancer tissues by immunohistochemistry, revealing its potential role in tumorigenesis/carcinogenesis.
  • With a nested-touchdown PCR program we were able to detect the tMK in all human tumor/cancer tissues and cancer/tumor cell lines.
  • Detection of MK in the peripheral cells and precancerous lesions implies its potential for early cancer/tumor diagnosis.
  • Furthermore, we have discovered two novel truncations of the MK, tMKB and tMKC, respectively, in the disease specimens.
  • [MeSH-major] Cytokines / genetics. Insulinoma / genetics. Pancreatic Neoplasms / genetics
  • [MeSH-minor] Adult. Amino Acid Sequence. Cell Line, Tumor. Humans. Molecular Sequence Data. Mutation. Pancreas / metabolism. Reverse Transcriptase Polymerase Chain Reaction

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  • (PMID = 17379400.001).
  • [ISSN] 0304-3835
  • [Journal-full-title] Cancer letters
  • [ISO-abbreviation] Cancer Lett.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Cytokines; 137497-38-2 / midkine
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34. Fabbri HC, Mello MP, Soardi FC, Esquiaveto-Aun AM, Oliveira DM, Denardi FC, Moura-Neto A, Garmes HM, Baptista MT, Matos PS, Lemos-Marini SH, D'Souza-Li LF, Guerra-Júnior G: Long-term follow-up of an 8-year-old boy with insulinoma as the first manifestation of a familial form of multiple endocrine neoplasia type 1. Arq Bras Endocrinol Metabol; 2010 Nov;54(8):754-60
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  • [Title] Long-term follow-up of an 8-year-old boy with insulinoma as the first manifestation of a familial form of multiple endocrine neoplasia type 1.
  • Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant hereditary cancer syndrome characterized mostly by parathyroid, enteropancreatic, and anterior pituitary tumors.
  • His diagnosis was pancreatic insulinoma.
  • At a first evaluation, the father presented only gastric ulceration but subsequently developed hyperparathyroidism and lung carcinoid tumor.
  • Molecular study showed a G to A substitution in intron 4, at nine nucleotides upstream of the splicing acceptor site, causing a splicing mutation.
  • [MeSH-major] Insulinoma / genetics. Multiple Endocrine Neoplasia Type 1 / genetics. Pancreatic Neoplasms / genetics. Proto-Oncogene Proteins / genetics


35. Strong VE, Shifrin A, Inabnet WB: Rapid intraoperative insulin assay: a novel method to differentiate insulinoma from nesidioblastosis in the pediatric patient. Ann Surg Innov Res; 2007;1:6
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  • [Title] Rapid intraoperative insulin assay: a novel method to differentiate insulinoma from nesidioblastosis in the pediatric patient.
  • Causes can include nesidioblastosis, pancreatic islet cell tumors such as insulinoma, and associations with multiple endocrine neoplasia syndromes.
  • Although new, improved imaging techniques have allowed for more precise preoperative localization of insulinomas, the differentiation of nesidioblastosis and insulinoma, particularly in children, can be challenging.
  • To improve intraoperative localization and confirmation of successful resection of insulinoma, a novel hormonal assay, the rapid intraoperative insulin assay, is reported for the first time in a pediatric patient.
  • This intraoperative radioimmunoassay for insulin yields results within several minutes and confirms complete resection of insulinoma.
  • CASE DESCRIPTION: We present a case of pancreatic insulinoma in a child with symptoms of severe hypoglycemia, causing seizures.
  • The insulinoma was enucleated laparoscopically, and rapid intra-operative insulin assay used to determine the success of the procedure.
  • DISCUSSION AND EVALUATION: This rapid intra-operative test provides a valuable adjunct for determining complete excision in complicated cases of recurrent or questionable insulinoma.
  • Although not a common problem, for pediatric patients in whom the diagnosis is not clear, this test may provide a novel approach to confirming disease.

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  • (PMID = 17958895.001).
  • [ISSN] 1750-1164
  • [Journal-full-title] Annals of surgical innovation and research
  • [ISO-abbreviation] Ann Surg Innov Res
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2116998
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36. Apodaca-Torrez FR, Triviño T, Lobo EJ, Goldenberg A, Benvenuto MR, Ardeng JC: [Pancreatic insulinomas]. Cir Esp; 2006 Jul;80(1):3-8
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  • [Title] [Pancreatic insulinomas].
  • [Transliterated title] Insulinoma de páncreas.
  • Insulinoma is the most frequent neuroendocrine pancreatic tumor.
  • The most frequently performed surgical procedures were pancreatic resection in 10 patients and laparotomic enucleation in the remaining 10.
  • The most frequent surgical complication was pancreatic fistula.
  • [MeSH-major] Insulinoma. Pancreatic Neoplasms

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  • (PMID = 16796946.001).
  • [ISSN] 0009-739X
  • [Journal-full-title] Cirugía española
  • [ISO-abbreviation] Cir Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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37. Toniato A, Meduri F, Foletto M, Avogaro A, Pelizzo M: Laparoscopic treatment of benign insulinomas localized in the body and tail of the pancreas: a single-center experience. World J Surg; 2006 Oct;30(10):1916-9; discussion 1920-1
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  • [Title] Laparoscopic treatment of benign insulinomas localized in the body and tail of the pancreas: a single-center experience.
  • BACKGROUND: The increasingly widespread use of minimally invasive surgery has allowed surgeons to exploit this approach for complex procedures, such as pancreatic resections, though its actual role outside simple operations remains debated.
  • METHODS: This is a study of 12 consecutive patients, 5 men and 7 women, with pancreatic insulinoma who were treated at our institution from 2000 to September 2005.
  • RESULTS: Successful laparoscopic resection was performed in 11 out of 12 patients: 4 had tumor enucleation, and 7 had distal pancreatectomy; among these latter 5 had spleen-preserving distal pancreatectomy.
  • The median tumor size was 18 mm, and all the insulinomas were benign.
  • CONCLUSIONS: The laparoscopic approach proved to be feasible and safe, although the average operative time was longer and demanded good surgical skills as well as precise localization of the tumor and definition of its nature.
  • Tumors located in the body or tail of the pancreas that are benign in nature can better benefit of laparoscopic approach.
  • [MeSH-major] Insulinoma / surgery. Laparoscopy. Pancreas. Pancreatectomy / methods. Pancreatic Neoplasms / surgery

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  • (PMID = 16855802.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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38. Pagliarini DJ, Wiley SE, Kimple ME, Dixon JR, Kelly P, Worby CA, Casey PJ, Dixon JE: Involvement of a mitochondrial phosphatase in the regulation of ATP production and insulin secretion in pancreatic beta cells. Mol Cell; 2005 Jul 22;19(2):197-207
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Involvement of a mitochondrial phosphatase in the regulation of ATP production and insulin secretion in pancreatic beta cells.
  • Reversible phosphorylation is the cell's most prevalent form of posttranslational modification, yet its role in the regulation of mitochondrial functions is poorly understood.
  • Knockdown of PTPMT1 expression in the pancreatic insulinoma cell line INS-1 832/13 alters the mitochondrial phosphoprotein profile and markedly enhances both ATP production and insulin secretion.
  • These data define PTPMT1 as a potential drug target for the treatment of type II diabetes and strengthen the notion that mitochondria are an underappreciated site of signaling by reversible phosphorylation.

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  • [CommentIn] Mol Cell. 2005 Aug 5;19(3):291-2 [16061174.001]
  • (PMID = 16039589.001).
  • [ISSN] 1097-2765
  • [Journal-full-title] Molecular cell
  • [ISO-abbreviation] Mol. Cell
  • [Language] ENG
  • [Grant] United States / NIDDK NIH HHS / DK / F32 DK067799; United States / PHS HHS / / 18024; United States / NIGMS NIH HHS / GM / 2 T32 GM07752-25
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Insulin; 8L70Q75FXE / Adenosine Triphosphate; EC 3.1.3.48 / Protein Tyrosine Phosphatases
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39. Jonnakuty C, Gragnoli C: Karyotype of the human insulinoma CM cell line--beta cell model in vitro? J Cell Physiol; 2007 Dec;213(3):661-2
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  • [Title] Karyotype of the human insulinoma CM cell line--beta cell model in vitro?
  • The CM cell line is derived from a human pancreatic insulinoma and is used as a beta cell model for the study of the pathogenesis of diabetes, as it appears to maintain the characteristics of beta cells.
  • However, a karyotype study of the CM cell line was not previously performed.
  • We aimed at karyotyping the CM cell line to confirm its human origin, diploid karyotype, and chromosomal structure.
  • We karyotyped the CM cells at earlier passages with the standard Giemsa technique.
  • The karyotyping procedure confirmed the human origin of the CM cell line.
  • However, the karyotype showed 64 chromosomes with structural abnormalities, including chromosome 11, in which the insulin gene is located.
  • Our Medline search of other existing insulinoma cell lines of rodent, mouse and hamster origin did not show any karyotype performed.
  • As the CM cell karyotype reveals significant structural and numerical chromosomal abnormalities, we question the use of such a cell line as an in vitro beta cell model.
  • We suggest that insulinoma cell lines established in vitro to study beta cell function should have a karyotype performed to exclude chromosomal aberrations.
  • [MeSH-major] Chromosome Aberrations. Insulinoma / genetics. Islets of Langerhans / cytology. Models, Biological. Pancreatic Neoplasms / genetics
  • [MeSH-minor] Cell Line, Tumor. Chromosomes, Human, Pair 11. Diploidy. Humans. In Vitro Techniques. Insulin / genetics. Karyotyping / methods

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  • [Copyright] 2007 Wiley-Liss, Inc.
  • [CommentIn] J Cell Physiol. 2008 Aug;216(2):568 [18300264.001]
  • (PMID = 17492774.001).
  • [ISSN] 1097-4652
  • [Journal-full-title] Journal of cellular physiology
  • [ISO-abbreviation] J. Cell. Physiol.
  • [Language] eng
  • [Publication-type] Editorial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Insulin
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40. Ketari-Jamoussi S, Debbiche-Chedly A, Ben Dhaou B, Boussema F, Cherif O, Cherif AR, Ben Ayed M, Bouzaine A, Rokbani L: [Giant insulinoma]. Ann Endocrinol (Paris); 2009 Mar;70(1):71-5
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  • [Title] [Giant insulinoma].
  • [Transliterated title] Un insulinome géant : à propos d'un cas.
  • Islet-cell tumors are the most common neuroendocrine tumors that arise from the endocrine pancreas.
  • The insulinoma is difficult to localize since it is very small in size, often not exceeding 2cm.
  • We report an exceptional case of giant insulinoma initially revealed by a pseudo-polycythemia in an 80-year-old man.
  • Routine biological investigations showed elevated hematocrit and haemoglobin, suggesting Vaquez disease.
  • Imaging studies showed a voluminous tumor located between the pancreas and the spleen.
  • The presence of an insulinoma was confirmed on the basis of an elevated level of proinsulin at the time of an asymptomatic episode of hypoglycemia.
  • Histopathological examination revealed a malignant, well-differentiated neuroendocrine malignant tumor.
  • [MeSH-major] Insulinoma / pathology. Insulinoma / surgery. Pancreatic Neoplasms / pathology. Pancreatic Neoplasms / surgery

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  • (PMID = 18937931.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 9035-68-1 / Proinsulin
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41. Arao T, Okada Y, Hirose A, Tanaka Y: A rare case of adult-onset nesidioblastosis treated successfully with diazoxide. Endocr J; 2006 Feb;53(1):95-100

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  • Abdominal CT revealed no pancreatic tumor, and angiography of splenic artery showed no definite tumor stain within the pancreas.
  • Based on the results of selective arterial calcium stimulation and hepatic venous sampling (ASVS), the provisional diagnosis was a small insulinoma in the pancreatic body.
  • However, histopathological and immunohistochemical examinations of the resected tissue showed hypertrophy of islets of Langerhans islands and beta cells around pancreatic ducts.
  • [MeSH-minor] Angiography. Blood Glucose / analysis. Diagnosis, Differential. Humans. Hyperinsulinism / blood. Hypoglycemia / blood. Insulin-Secreting Cells / pathology. Insulinoma / diagnosis. Insulinoma / pathology. Liver / blood supply. Male. Middle Aged. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / pathology

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  • (PMID = 16543678.001).
  • [ISSN] 0918-8959
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Blood Glucose; 0 / Vasodilator Agents; O5CB12L4FN / Diazoxide
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42. Cheon H, Cho JM, Kim S, Baek SH, Lee MK, Kim KW, Yu SW, Solinas G, Kim SS, Lee MS: Role of JNK activation in pancreatic beta-cell death by streptozotocin. Mol Cell Endocrinol; 2010 Jun 10;321(2):131-7
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  • [Title] Role of JNK activation in pancreatic beta-cell death by streptozotocin.
  • c-Jun N-terminal kinase (JNK) is activated by cellular stress and plays critical roles in diverse types of cell death.
  • However, role of JNK in beta-cell injury is obscure.
  • We investigated the role for JNK in streptozotocin (STZ)-induced beta-cell death.
  • STZ induced JNK activation in insulinoma or islet cells.
  • JNK inhibitors attenuated insulinoma or islet cell death by STZ.
  • PARP-1 siRNA attenuated insulinoma cell death and JNK activation after STZ treatment, which was reversed by MKP (MAP kinase phosphatase)-1 siRNA.
  • These results suggest that JNK is activated by STZ downstream of PARP-1 through inactivation of phosphatases such as MKP, which plays important roles in STZ-induced beta-cell death.
  • [MeSH-major] Antibiotics, Antineoplastic / pharmacology. Cell Death / drug effects. Enzyme Activation / drug effects. Insulin-Secreting Cells / drug effects. JNK Mitogen-Activated Protein Kinases / metabolism. Streptozocin / pharmacology

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  • [Copyright] Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
  • (PMID = 20176078.001).
  • [ISSN] 1872-8057
  • [Journal-full-title] Molecular and cellular endocrinology
  • [ISO-abbreviation] Mol. Cell. Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Enzyme Inhibitors; 0 / Poly(ADP-ribose) Polymerase Inhibitors; 0 / Reactive Oxygen Species; 5W494URQ81 / Streptozocin; EC 2.4.2.30 / Parp1 protein, mouse; EC 2.4.2.30 / Poly(ADP-ribose) Polymerases; EC 2.7.11.24 / JNK Mitogen-Activated Protein Kinases
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43. Lee SR, Choi MC, Ahn KJ: A case of multiple endocrine neoplasia type 1 with primary liver gastrinoma. J Korean Med Sci; 2010 Jun;25(6):953-6
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  • Gastrinoma is the most frequent functional pancreaticoduodenal endocrine tumor in patients with multiple endocrine neoplasia type 1 (MEN 1).
  • We reported the case of a 39 yr old female patient with a history of repeated peptic ulcers and a hypoglycemia episode.
  • Abdominal CT indicated a well-defined liver mass and a pancreatic head mass.
  • Somatostatin-receptor scintigraphy with [(111)In] DTPA octreotide demonstrated a strong uptake of the radiotracer in the left lateral segment at the site of the hepatic mass.
  • After operation, immunohistochemical staining was consistent with pancreatic insulinoma and primary hepatic gastrinoma.
  • As the liver is a common site of metastases from gastrinoma, primary liver gastrinoma has not yet been reported with MEN 1.
  • [MeSH-minor] Adult. Female. Humans. Hypoglycemia / etiology. Insulinoma / complications. Insulinoma / diagnosis. Insulinoma / pathology. Mastectomy, Segmental. Pancreatic Neoplasms / complications. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / pathology. Peptic Ulcer / etiology. Tomography, X-Ray Computed

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  • [Journal-full-title] Journal of Korean medical science
  • [ISO-abbreviation] J. Korean Med. Sci.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2877224
  • [Keywords] NOTNLM ; Gastrinoma / Insulinoma / Multiple Endocrine Neoplasia Type 1
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44. Kang CM, Park SH, Kim KS, Choi JS, Lee WJ, Kim BR: Surgical experiences of functioning neuroendocrine neoplasm of the pancreas. Yonsei Med J; 2006 Dec 31;47(6):833-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Surgical experiences of functioning neuroendocrine neoplasm of the pancreas.
  • We present our surgical experiences with functioning neuroendocrine neoplasms of the pancreas to define its natural history, and to suggest its proper management.
  • From June 1990 to June 2005, patients with diagnosis of functioning neuroendocrine (islet cell) neoplasms of the pancreas were retrospectively reviewed.
  • Twelve patients (86%) had insulinoma, two (14%) had gastrinoma.
  • One (7%) with pancreatic insulinoma was multiple endocrine neoplasia type 1.
  • Intraoperative ultrasound scan (sensitivity, 83%) was the most powerful modality for tumor localization.
  • Fifteen neoplasms with median tumor size 1 cm (range 0-3 cm) were resected.
  • Four insulinomas (26.7%) were located in the head of the pancreas and 5 (36%), in the tail.
  • Another 5 (36%) insulinomas and 1 (7%) gastrinoma were located around the neck area near the SMV or PV.
  • 100% of patients with functioning neuroendocrine neoplasms of the pancreas have survived.
  • The overall disease free 10-year survival was found to be about 81%.
  • Exact localization of tumor by intraoperative ultrasound and surgical removal are promising for good prognosis.
  • [MeSH-major] Insulinoma / surgery. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Female. Gastrinoma / surgery. Gastrinoma / ultrasonography. Humans. Male. Middle Aged. Neoplasm Metastasis. Postoperative Complications. Prognosis. Retrospective Studies

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  • (PMID = 17191313.001).
  • [ISSN] 0513-5796
  • [Journal-full-title] Yonsei medical journal
  • [ISO-abbreviation] Yonsei Med. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2687824
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45. Bourcier ME, Sherrod A, DiGuardo M, Vinik AI: Successful control of intractable hypoglycemia using rapamycin in an 86-year-old man with a pancreatic insulin-secreting islet cell tumor and metastases. J Clin Endocrinol Metab; 2009 Sep;94(9):3157-62
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  • [Title] Successful control of intractable hypoglycemia using rapamycin in an 86-year-old man with a pancreatic insulin-secreting islet cell tumor and metastases.
  • CONTEXT: Insulinomas are rare tumors of the pancreatic islet cells that produce insulin.
  • Approximately 5 to 10% of these tumors are cancerous, and control of insulin secretion and hypoglycemia may be difficult in these patients.
  • Malignant insulinomas generally respond poorly to traditional chemotherapeutic agent regimens.
  • At present, streptozotocin is the only approved drug for the treatment of pancreatic islet cell tumors.
  • SETTING AND PATIENT: This report describes a case of an elderly gentleman with a metastatic pancreatic insulinoma and severe hypoglycemia.
  • He required diazoxide, a thiazide diuretic, phenytoin, and a constant infusion of glucose to control the hypoglycemia and elevated insulin levels.
  • RESULTS: On the mTOR (mammalian target of rapamycin) agent rapamycin, he was weaned off all drugs except for the thiazide diuretic and maintained euglycemia with a reduction of circulating insulin levels.
  • He remained euglycemic for the past year with no evidence of tumor progression based on Octreoscan.
  • CONCLUSIONS: Rapamycin may provide a useful means of abrogating tumor growth and controlling hypoglycemia in malignant insulinomas by reducing the malignant beta-cell growth and proliferation as well as inhibiting insulin production.
  • [MeSH-major] Adenoma, Islet Cell / drug therapy. Hypoglycemia / drug therapy. Pancreatic Neoplasms / drug therapy. Sirolimus / therapeutic use

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  • (PMID = 19567519.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0J48LPH2TH / Hydrochlorothiazide; 5W494URQ81 / Streptozocin; W00SSD35VW / buthiazide; W36ZG6FT64 / Sirolimus
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46. Reubi JC, Perren A, Rehmann R, Waser B, Christ E, Callery M, Goldfine AB, Patti ME: Glucagon-like peptide-1 (GLP-1) receptors are not overexpressed in pancreatic islets from patients with severe hyperinsulinaemic hypoglycaemia following gastric bypass. Diabetologia; 2010 Dec;53(12):2641-5
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  • [Title] Glucagon-like peptide-1 (GLP-1) receptors are not overexpressed in pancreatic islets from patients with severe hyperinsulinaemic hypoglycaemia following gastric bypass.
  • AIMS/HYPOTHESIS: Glucagon-like peptide-1 (GLP-1) receptors are highly overexpressed in benign insulinomas, permitting in vivo tumour visualisation with GLP-1 receptor scanning.
  • The present study sought to evaluate the GLP-1 receptor status in vitro in other pancreatic disorders leading to hyperinsulinaemic hypoglycaemia, specifically after gastric bypass surgery.
  • METHODS: Fresh frozen pancreatic tissue samples (n=7) from six gastric bypass surgery patients suffering from hyperinsulinaemic hypoglycaemia were evaluated for GLP-1 receptor content using in vitro receptor autoradiography, and compared with normal pancreas and with pancreatic insulinoma tissues.
  • RESULTS: GLP-1 receptor analysis of the pancreatic tissues, which histopathologically were compatible with nesidioblastosis and originated from post-bypass hypoglycaemic patients, revealed a mean density value of GLP-1 receptors in the islets of 1,483 ± 183 dpm/mg tissue.
  • The density of islet GLP-1 receptor in post-gastric bypass patients did not differ from that of normal pancreas (1,563 ± 104 dpm/mg tissue, n = 10).
  • Receptor density in pancreatic acini was low in post-bypass and control conditions.
  • In contrast, benign insulinomas showed a high density of GLP-1 receptors, with a mean value of 8,302 ± 1,073 dpm/mg tissue (n = 6).
  • CONCLUSIONS/INTERPRETATION: In contrast to insulinoma, hyperinsulinaemic hypoglycaemia after gastric bypass surgery is not accompanied by overexpression of GLP-1 receptor in individual islets.
  • These GLP-1 receptor data support the notion that the islet pathobiology of post-gastric bypass hypoglycaemia is distinctly different from that of benign insulinomas.
  • [MeSH-minor] Adult. Aged. Autoradiography. Female. Glucagon-Like Peptide-1 Receptor. Humans. Insulinoma / metabolism. Insulinoma / pathology. Male. Middle Aged. Pancreatic Neoplasms / metabolism. Pancreatic Neoplasms / pathology. Severity of Illness Index. Up-Regulation

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  • [Cites] N Engl J Med. 2005 Jul 21;353(3):249-54 [16034010.001]
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  • (PMID = 20835917.001).
  • [ISSN] 1432-0428
  • [Journal-full-title] Diabetologia
  • [ISO-abbreviation] Diabetologia
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / GLP1R protein, human; 0 / Glucagon-Like Peptide-1 Receptor; 0 / Receptors, Glucagon
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47. Diaz AG, Lucas S, Ferraina P, Ferraro A, Puchulu F, Paes De Lima A, Maselli Mdel C, Gomez RM, Bruno OD: [Clinical experience in 37 cases of insulinoma]. Medicina (B Aires); 2006;66(6):499-504
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  • [Title] [Clinical experience in 37 cases of insulinoma].
  • [Transliterated title] Experiencia clinica sobre 37 casos de insulinoma.
  • Insulinoma is the most frequent pancreatic islet cell tumor.
  • Diagnosis is established through demonstration of inappropriately elevated insulin serum concentrations in the presence of hypoglycemia.
  • The aim of this study is to show our experience in the management of insulinoma.
  • Mean fasting serum glucose was 32.4 +/- 8.7 mg/dl, insulin 38.2 +/- 39.7 microU/ml (RIA, n=11) or 23.8 +/- 18.1 microU/ml (chemoluminescence, n=26) and C-peptide 1.15 +/- 1.60 nmol/l (n=14).
  • In 22 patients, a solitary tumor was excised (61.1%).
  • Six cases presented multiple insulinomas.
  • Five patients had malignant insulinomas.
  • In 3 patients another tumour (glucagonoma) was found (1 of them with MEN 1).
  • [MeSH-major] Insulinoma. Pancreatic Neoplasms
  • [MeSH-minor] Adolescent. Adult. Aged. Biopsy. Blood Glucose / analysis. Fasting. Female. Humans. Hypoglycemia / etiology. Insulin / blood. Male. Middle Aged. Pancreatectomy. Retrospective Studies

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  • (PMID = 17240619.001).
  • [ISSN] 0025-7680
  • [Journal-full-title] Medicina
  • [ISO-abbreviation] Medicina (B Aires)
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Argentina
  • [Chemical-registry-number] 0 / Blood Glucose; 0 / Insulin
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48. Bose AK, Mocanu MM, Carr RD, Brand CL, Yellon DM: Glucagon-like peptide 1 can directly protect the heart against ischemia/reperfusion injury. Diabetes; 2005 Jan;54(1):146-51
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  • Glucagon-like peptide 1 (GLP-1), a gut incretin hormone that stimulates insulin secretion, also activates antiapoptotic signaling pathways such as phosphoinositide 3-kinase and mitogen-activated protein kinase in pancreatic and insulinoma cells.
  • This finding may represent a new therapeutic potential for this class of drug currently undergoing clinical trials in the treatment of type 2 diabetes.
  • [MeSH-minor] Animals. Blood Pressure / drug effects. Butadienes / pharmacology. Chromones / pharmacology. Disease Models, Animal. Enzyme Inhibitors / pharmacology. Glucagon-Like Peptide 1. Heart Rate / drug effects. In Vitro Techniques. Insulin / secretion. MAP Kinase Signaling System / drug effects. MAP Kinase Signaling System / physiology. Male. Morpholines / pharmacology. Myocardial Infarction / pathology. Myocardial Infarction / prevention & control. Nitriles / pharmacology. Phosphatidylinositol 3-Kinases / antagonists & inhibitors. Rats. Rats, Sprague-Dawley. Time Factors

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  • (PMID = 15616022.001).
  • [ISSN] 0012-1797
  • [Journal-full-title] Diabetes
  • [ISO-abbreviation] Diabetes
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Butadienes; 0 / Chromones; 0 / Enzyme Inhibitors; 0 / Insulin; 0 / Morpholines; 0 / Nitriles; 0 / Peptide Fragments; 0 / Protein Precursors; 0 / U 0126; 154447-36-6 / 2-(4-morpholinyl)-8-phenyl-4H-1-benzopyran-4-one; 89750-14-1 / Glucagon-Like Peptide 1; 9007-92-5 / Glucagon; EC 2.7.1.- / Phosphatidylinositol 3-Kinases
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49. Marek B, Kajdaniuk D, Kos-Kudła B, Foltyn W, Borgiel-Marek H, Matyja V, Pakuła D: [Insulinoma--diagnosis and treatment]. Endokrynol Pol; 2007 Jan-Feb;58(1):58-62
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  • [Title] [Insulinoma--diagnosis and treatment].
  • [Transliterated title] Insulinoma--diagnostyka i leczenie.
  • Insulinomas are the most common functioning endocrine tumors of pancreas.
  • Approximately 10% are multiple, less than 10% can be malignant and 5-10% associated with the MEN-1 syndrome.
  • Insulinomas are the most common cause of hypoglycemia resulting from endogenous hyperinsulinism.
  • The aim of this lecture is to present the up-to-date information concerning the prevalence, diagnosis and treatment of insulinoma.
  • [MeSH-major] Insulinoma. Multiple Endocrine Neoplasia Type 1. Pancreatic Neoplasms

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  • (PMID = 17354206.001).
  • [ISSN] 0423-104X
  • [Journal-full-title] Endokrynologia Polska
  • [ISO-abbreviation] Endokrynol Pol
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Poland
  • [Number-of-references] 39
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50. Soucek L, Lawlor ER, Soto D, Shchors K, Swigart LB, Evan GI: Mast cells are required for angiogenesis and macroscopic expansion of Myc-induced pancreatic islet tumors. Nat Med; 2007 Oct;13(10):1211-8
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  • [Title] Mast cells are required for angiogenesis and macroscopic expansion of Myc-induced pancreatic islet tumors.
  • Myc is a pleiotropic transcription factor that is overexpressed in many human cancers and instructs many extracellular aspects of the tumor tissue phenotype, including remodeling of tumor stroma and angiogenesis.
  • Here we show in a beta-cell tumor model that activation of Myc in vivo triggers rapid recruitment of mast cells to the tumor site-a recruitment that is absolutely required for macroscopic tumor expansion.
  • In addition, treatment of established beta-cell tumors with a mast cell inhibitor rapidly triggers hypoxia and cell death of tumor and endothelial cells.
  • Inhibitors of mast cell function may therefore prove therapeutically useful in restraining expansion and survival of pancreatic and other cancers.
  • [MeSH-major] Cell Transformation, Neoplastic / genetics. Mast Cells / metabolism. Neovascularization, Pathologic / etiology. Pancreatic Neoplasms / blood supply. Proto-Oncogene Proteins c-myc / physiology
  • [MeSH-minor] Animals. Bone Marrow Cells / cytology. Cells, Cultured. Chemokine CCL2 / metabolism. Chemokine CCL5 / metabolism. Femur / cytology. Gene Expression Regulation, Neoplastic. Immunohistochemistry. Mice. Mice, Inbred C57BL. Mice, Transgenic. Oligonucleotide Array Sequence Analysis


51. Crespel A, Barbaud A, Andrieu JM, Oziole E, Coubes P, Gélisse P: [Insulinoma presenting as pseudo-drug-resistant focal epilepsy]. Rev Neurol (Paris); 2009 May;165(5):493-5
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  • [Title] [Insulinoma presenting as pseudo-drug-resistant focal epilepsy].
  • [Transliterated title] Un insulinome se présentant comme une épilepsie focale pharmacorésistante.
  • INTRODUCTION: We describe a case of insulinoma presenting as a refractory frontal lobe epilepsy in a 44-year-old man with a history of severe head trauma.
  • Insulinoma was diagnosed based on the presence of episodes of hypoglycemia, abnormal insulin/blood glucose ratio and a tumor in the pancreas (echo-ultrasound).
  • CONCLUSION: Insulinoma should be considered in patients with no reason for having drug-resistant epilepsy, especially when seizures occur early in the morning or when episodes of neuropsychiatric symptoms with sweating are present.
  • [MeSH-major] Epilepsies, Partial / etiology. Insulinoma / diagnosis
  • [MeSH-minor] Adult. Blood Glucose / metabolism. Humans. Hypoglycemia / etiology. Insulin / blood. Male. Pancreatectomy. Seizures / epidemiology. Treatment Outcome. Weight Gain

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  • (PMID = 18926551.001).
  • [ISSN] 0035-3787
  • [Journal-full-title] Revue neurologique
  • [ISO-abbreviation] Rev. Neurol. (Paris)
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Blood Glucose; 0 / Insulin
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52. Dadan J, Wojskowicz P, Wojskowicz A: Neuroendocrine tumors of the pancreas. Wiad Lek; 2008;61(1-3):43-7
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  • [Title] Neuroendocrine tumors of the pancreas.
  • The neuroendocrine tumors (NET) of the pancreas are very rare lesions with frequency of about 3 to 10 per 1 000 000 inhabitants.
  • The neuroendocrine tumors composes a heterogeneous group of tumors.
  • The gastro-entero-pancreatic tumors (GEP) constitute 70% of all NET and 2% of all digestive system tumors.
  • There have been several attempts to classify those lesions and since 2000 exists WHO classification which divides NET according to malignancy and histologic structure.
  • The most often NET of the pancreas are insulinoma, gastrinoma, glucagonoma, somatostatinoma, VIPoma.
  • There is a recommendation to assay hormonal activity, measure concentration of specific peptides, biogenic amines and hormones produced by NET cells to establish diagnosis.
  • Those tests are useful in monitoring treatment and in prognostication course of the disease.
  • Imaging methods especially useful in localization GEP-NET are: ultrasound (US), endoscopic ultrasound (EUS), somatostatin receptor scintigraphy (SRS), computer tomography (CT), magnetic resonance (MR) and angiography.
  • Surgical treatment depends on progression of disease as well as on localization of tumor and consists in both radical methods and palliative operations.
  • Although NET of pancreas are very rare. they are still important diagnostic and therapeutic problem and requires interdisciplinary co-operation.
  • The neuroendocrine tumors should be treated in centers with highest rank of references.
  • [MeSH-major] Carcinoma, Islet Cell / diagnosis. Carcinoma, Islet Cell / therapy. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / therapy
  • [MeSH-minor] Gastrinoma / diagnosis. Gastrinoma / metabolism. Gastrinoma / therapy. Glucagonoma / diagnosis. Glucagonoma / metabolism. Glucagonoma / therapy. Humans. Insulinoma / diagnosis. Insulinoma / metabolism. Insulinoma / therapy. Somatostatinoma / diagnosis. Somatostatinoma / metabolism. Somatostatinoma / therapy. Vipoma / diagnosis. Vipoma / metabolism. Vipoma / therapy

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  • (PMID = 18717042.001).
  • [ISSN] 0043-5147
  • [Journal-full-title] Wiadomości lekarskie (Warsaw, Poland : 1960)
  • [ISO-abbreviation] Wiad. Lek.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Poland
  • [Number-of-references] 30
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53. Twardowschy CA, Leite SA, Outi TY, Dykyj MT: [Insulinoma presenting as seizure: case report]. Arq Neuropsiquiatr; 2005 Sep;63(3A):685-8
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  • [Title] [Insulinoma presenting as seizure: case report].
  • [Transliterated title] Insulinoma apresentando-se como crise convulsiva: relato de caso.
  • Insulinoma is a rare disease presenting with episodic neuroglycopenic and/or adrenergic symptoms.
  • We describe the case of a 36 year-old female that had been in treatment for complex partial seizures during 4 years without improvement.
  • A 72-hour fast test showed hypoglycemic symptoms with raised insulin and C-peptide.
  • The insulinoma localization was possible during exploratory laparatomy; image methods did not reveal the tumor.
  • Histological findings confirmed an insulinoma.
  • We conclude that blood glucose level should be requested during the investigation of convulsive and behavioral disorders since an insulinoma can present like them.
  • [MeSH-major] Hypoglycemia / etiology. Insulinoma / complications. Pancreatic Neoplasms / complications. Seizures / etiology

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  • (PMID = 16172725.001).
  • [ISSN] 0004-282X
  • [Journal-full-title] Arquivos de neuro-psiquiatria
  • [ISO-abbreviation] Arq Neuropsiquiatr
  • [Language] por
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Brazil
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54. Butte JM, Montero PH, Solar A, Torres J, Olmos PR, Goñi I, Quintana JC, Martínez J, Llanos O: Cervical metastases of glucagonoma in a patient with multiple endocrine neoplasia type 1: report of a case. Surg Today; 2008;38(12):1137-43
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  • [Title] Cervical metastases of glucagonoma in a patient with multiple endocrine neoplasia type 1: report of a case.
  • Multiple endocrine neoplasia type 1 (MEN 1) is a syndrome characterized by tumors of the parathyroid glands, pancreatic islet cells, duodenum, and pituitary gland.
  • Computed tomography (CT) showed two hypervascular lesions in the tail of the pancreas and cervical ultrasound showed multiple hypoechogenic ovoid images in the neck.
  • A cervical CT scan confirmed two 15-mm lymph nodes in the left cervical region and 111In-DOTATOC imaging showed focal abnormal somatostatin expression in the pancreatic tail and the cervical nodes.
  • The patient had asymptomatic hypoglycemic episodes, with blood sugar levels as low as 30 mg/dl, which raised our suspicion of MEN 1 associated with pancreatic insulinoma.
  • Histopathological examination revealed 12 pancreatic tumors as well as metastases in four cervical lymph nodes.
  • A follow-up CT scan, 18 months after surgery, showed new tumors in the head of the pancreas and in the duodenal wall.
  • A pancreatoduodenectomy was performed and histopathological examination revealed nine nonfunctioning endocrine tumors in the pancreas, one tumor in the duodenal wall, and metastases in two peripancreatic lymph nodes.
  • [MeSH-major] Glucagonoma / pathology. Multiple Endocrine Neoplasia Type 1 / pathology. Pancreatic Neoplasms / pathology


55. Kauhanen S, Seppänen M, Minn H, Gullichsen R, Salonen A, Alanen K, Parkkola R, Solin O, Bergman J, Sane T, Salmi J, Välimäki M, Nuutila P: Fluorine-18-L-dihydroxyphenylalanine (18F-DOPA) positron emission tomography as a tool to localize an insulinoma or beta-cell hyperplasia in adult patients. J Clin Endocrinol Metab; 2007 Apr;92(4):1237-44
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  • [Title] Fluorine-18-L-dihydroxyphenylalanine (18F-DOPA) positron emission tomography as a tool to localize an insulinoma or beta-cell hyperplasia in adult patients.
  • CONTEXT AND OBJECTIVE: Fluorine-18-L-dihydroxyphenylalanine (18F-DOPA) positron emission tomography (PET) is a promising method in localizing neuroendocrine tumors.
  • The current study was set up to determine the potential of 18F-DOPA PET in identifying the insulin-secreting tumors or beta-cell hyperplasia of the pancreas in adults.
  • PATIENTS AND METHODS: We prospectively studied 10 patients with confirmed hyperinsulinemic hypoglycemia and presumed insulin-secreting tumor using 18F-DOPA PET.
  • Semiquantitative PET findings in the pancreas using standardized uptake values were compared to standardized uptake values of seven consecutive patients with nonpancreatic neuroendocrine tumors.
  • RESULTS: By visual inspection of 18F-DOPA PET images, it was possible in nine of 10 patients to localize the pancreatic lesion, subsequently confirmed by histological analysis.
  • 18F-DOPA uptake was enhanced in six of seven solid insulinomas and in the malignant insulinoma and its hepatic metastasis.
  • Two patients with beta-cell hyperplasia showed increased focal uptake of 18F-DOPA in the affected areas.
  • As compared to CT or MRI, 18F-DOPA PET was more sensitive in localizing diseased pancreatic tissue.
  • CONCLUSION: 18F-DOPA PET was useful in most patients with insulinoma and negative CT, MRI, and ultrasound results.
  • In agreement with previous findings in infants, preoperative 18F-DOPA imaging seems to be a method of choice for the detection of beta-cell hyperplasia in adults.
  • It should be considered for the detection of insulinoma or beta-cell hyperplasia in patients with confirmed hyperinsulinemic hypoglycemias when other diagnostic work-up is negative.
  • [MeSH-major] Dihydroxyphenylalanine / analogs & derivatives. Insulin-Secreting Cells / radionuclide imaging. Insulinoma / radionuclide imaging. Pancreatic Neoplasms / radionuclide imaging

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  • (PMID = 17227804.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 42877-15-6 / 5-fluorodopa; 63-84-3 / Dihydroxyphenylalanine
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56. Mathur A, Gorden P, Libutti SK: Insulinoma. Surg Clin North Am; 2009 Oct;89(5):1105-21
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  • [Title] Insulinoma.
  • Insulinoma is a rare neuroendocrine tumor with an incidence of 4 per 1 million persons per year, which may occur as a unifocal sporadic event in patients without an inherited syndrome or as a part of multiple endocrine neoplasia type 1.
  • Once the diagnosis is established, the insulinoma is preoperatively localized within the pancreas with the goal of surgical excision for cure.
  • This review discusses the historical background, diagnosis, and management of sporadic insulinoma.
  • [MeSH-major] Insulinoma / surgery. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Combined Modality Therapy. Diagnosis, Differential. Diagnostic Imaging. Humans. Liver Transplantation. Neoplasm Metastasis

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  • (PMID = 19836487.001).
  • [ISSN] 1558-3171
  • [Journal-full-title] The Surgical clinics of North America
  • [ISO-abbreviation] Surg. Clin. North Am.
  • [Language] eng
  • [Grant] United States / Intramural NIH HHS / / Z99 DK999999
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 69
  • [Other-IDs] NLM/ NIHMS410902; NLM/ PMC3470467
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57. Gurlo T, Ryazantsev S, Huang CJ, Yeh MW, Reber HA, Hines OJ, O'Brien TD, Glabe CG, Butler PC: Evidence for proteotoxicity in beta cells in type 2 diabetes: toxic islet amyloid polypeptide oligomers form intracellularly in the secretory pathway. Am J Pathol; 2010 Feb;176(2):861-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evidence for proteotoxicity in beta cells in type 2 diabetes: toxic islet amyloid polypeptide oligomers form intracellularly in the secretory pathway.
  • The islet in type 2 diabetes mellitus (T2DM) is characterized by a deficit in beta cells and islet amyloid derived from islet amyloid polypeptide (IAPP), a protein co-expressed with insulin by beta cells.
  • Using an antibody specific for toxic oligomers and cryo-immunogold labeling in human IAPP transgenic mice, human insulinoma and pancreas from humans with and without T2DM, we sought to establish the abundance and sites of formation of IAPP toxic oligomers.

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  • (PMID = 20042670.001).
  • [ISSN] 1525-2191
  • [Journal-full-title] The American journal of pathology
  • [ISO-abbreviation] Am. J. Pathol.
  • [Language] ENG
  • [Grant] United States / NIDDK NIH HHS / DK / R01 DK059579; United States / NIDDK NIH HHS / DK / DK059579
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Amyloid; 0 / Islet Amyloid Polypeptide
  • [Other-IDs] NLM/ PMC2808091
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58. Shcherbinina MB, Kosinskaia SV, Fateeva TV, Gaĭdar IuA: [Insulinoma]. Klin Med (Mosk); 2008;86(2):70-6
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  • [Title] [Insulinoma].
  • The authors review statistical, pathogenic, and clinical aspects of insulinima, a rare pancreatic tumor growing from beta-cells of islets of Langerhans.
  • Its functioning is associated with periodical impulsive ejection of insulin, its precursors, and relative peptides in large quantities, which results in hypoglycemic state.
  • When consciousness remains, the leading clinical syndrome is vegetative dysfunction.
  • The article describes diagnostic methods in insulinoma; their informative value is evaluated.
  • The authors describe their own observation of insulinoma, which illustrates difficulties in its revealing.
  • At the same time, the authors affirm that sufficient information make it possible for doctors to establish timely diagnosis of this disease.
  • [MeSH-major] Insulinoma. Pancreatic Neoplasms

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  • (PMID = 18368799.001).
  • [ISSN] 0023-2149
  • [Journal-full-title] Klinicheskaia meditsina
  • [ISO-abbreviation] Klin Med (Mosk)
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Russia (Federation)
  • [Number-of-references] 18
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59. Adsay NV: Cystic neoplasia of the pancreas: pathology and biology. J Gastrointest Surg; 2008 Mar;12(3):401-4
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  • [Title] Cystic neoplasia of the pancreas: pathology and biology.
  • In contrast with solid tumors, most of which are invasive ductal adenocarcinoma with dismal prognosis, cystic lesions of the pancreas are often either benign or low-grade indolent neoplasia.
  • While many are innocuous adenomas--in particular, those that are small and less complex, and in the case of IPMN, those that are branch-duct type are more commonly benign, some harbor or progress into in situ or invasive carcinomas.
  • For this reason, pancreatic cysts with mucinous differentiation ought to be evaluated carefully, preferably by experts familiar with subtle evidences of malignancy in these tumors.
  • The presence of ovarian-type stroma has now almost become a requirement for the diagnosis of MCN, and when defined as such, MCN is seen almost exclusively in women of perimenopausal age group as thick-walled multilocular cystic mass in the tail of the pancreas in contrast with IPMN which afflicts an elder population, both genders in almost equal numbers, and occur predominantly in the head of the organ.
  • While mucinous lesions have well-established pre-malignant properties, most of the entities that fall into the nonmucinous true cyst category such as serous tumors, lymphoepithelial cysts, congenital cysts, and squamoid cyst of ducts have virtually no malignant potential.
  • In contrast, the rare cystic tumors that occur as a result of degenerative/necrotic changes in otherwise solid neoplasia such as the rare cystic ductal adenocarcinomas, cystic endocrine neoplasia, and most importantly, solid-pseudopapillary tumor (SPT) in which cystic change is so common that it used to be incorporated into its name ("solid-cystic," "papillary-cystic") are malignant neoplasia, albeit variable degrees of aggressiveness.
  • SPT holds a distinctive place among pancreatic neoplasia because of its highly peculiar characteristics, undetermined cell lineage, occurrence almost exclusively in young females, association with beta-catenin pathway, and also by being a very low-grade curable malignancy.
  • In conclusion, cystic lesions in the pancreas constitute a biologically and pathologically diverse category most (but not all) of which are either benign or treatable diseases; however, a substantial subset, especially mucinous ones, has malignant potential that requires careful analysis.
  • [MeSH-major] Adenoma / pathology. Carcinoma in Situ / pathology. Neoplasms, Cystic, Mucinous, and Serous / pathology. Pancreatic Ducts / pathology. Pancreatic Neoplasms / pathology. Precancerous Conditions / pathology
  • [MeSH-minor] Adenocarcinoma, Mucinous / mortality. Adenocarcinoma, Mucinous / pathology. Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Papillary / mortality. Carcinoma, Papillary / pathology. Cystadenoma / pathology. Cystadenoma, Serous / pathology. Dilatation, Pathologic. Humans. Necrosis

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  • (PMID = 17957438.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 19
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60. Valente TO, Bertevello PL, Waitzberg DL, Gama-Rodrigues J: [Laparoscopic surgical treatment of insulinomas with the use of intraoperative ultrasonography]. Arq Gastroenterol; 2007 Jan-Mar;44(1):22-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Laparoscopic surgical treatment of insulinomas with the use of intraoperative ultrasonography].
  • [Transliterated title] Tratamento cirúrgico videolaparoscópico de insulinomas utilizando ultra-sonografia intra-operatória.
  • BACKGROUND: Insulinoma are insulin productive tumors originated from the pancreatic beta cells with an incidence of 4/1 million persons.
  • It is more prevalent between the 5th and 6th decade, in women (2:1) and from the endocrine pancreatic tumor is the more frequent (50% to 60%).
  • Insulinoma behave as a benign tumor when the diameter is inferior to 2 cm.
  • METHODS: Five patients were studied (3 man and 2 women) with age from 20 to 53 years old, clinically diagnosed with insulinoma.
  • After image work out it was proposed nuclear resection of the insulinoma by laparoscopic technique associated to intraoperative ultrasonography.
  • RESULTS: The patients had a complete remission of tumor related hypoglycemia and one patient developed a pancreatic fistula and other a pancreatic pseudocist with good postoperative resolution.
  • CONCLUSIONS: The videolaparoscopic approach for the surgical treatment of insulinoma is feasible.
  • [MeSH-major] Insulinoma / surgery. Laparoscopy / methods. Pancreatic Neoplasms / surgery. Ultrasonography, Interventional

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  • (PMID = 17639178.001).
  • [ISSN] 0004-2803
  • [Journal-full-title] Arquivos de gastroenterologia
  • [ISO-abbreviation] Arq Gastroenterol
  • [Language] por
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Brazil
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61. Krysiak R, Okopień B, Herman ZS: [Insulinoma]. Pol Merkur Lekarski; 2007 Jan;22(127):70-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Insulinoma].
  • Insulinoma is considered the most common endocrine tumour of the pancreas with an annual prevalence of 4 cases per million people.
  • Contrary to the other endocrine tumours of this organ, over 90% of the insulinomas are benign in nature.
  • The clinical presentation of this neoplasm depends on excessive production of insulin and pro-insulin and is characterised by the symptoms of neuroglycopenia and catecholamine response.
  • Effective management requires directed biochemical testing, careful choice of preoperative imaging tests, and complete pancreatic exploration by an experienced endocrine surgeon utilising intraoperative ultrasound.
  • The only curative treatment for insulinoma is complete resection of the tumour.
  • The aim of this paper is to critically discuss contemporary diagnosis and treatment of this neoplasm on the basis of progress made in recent years.
  • [MeSH-major] Adenoma, Islet Cell / complications. Adenoma, Islet Cell / diagnosis. Insulinoma / complications. Insulinoma / diagnosis. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Endocrine Surgical Procedures / methods. Gastrinoma / complications. Gastrinoma / diagnosis. Gastrinoma / metabolism. Gastrinoma / surgery. Humans. Hypoglycemia / complications. Insulin / metabolism. Pancreatectomy / methods. Prognosis. Rare Diseases

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  • (PMID = 17477096.001).
  • [ISSN] 1426-9686
  • [Journal-full-title] Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
  • [ISO-abbreviation] Pol. Merkur. Lekarski
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Insulin
  • [Number-of-references] 34
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62. Wouters RS, van den Ouweland JM, Pouwels JG, Wolffenbuttel BH: [Missed hyperinsulinaemia in a patient with an insulinoma]. Ned Tijdschr Geneeskd; 2005 Apr 23;149(17):944-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Missed hyperinsulinaemia in a patient with an insulinoma].
  • [Transliterated title] Gemiste hyperinsulinemie bij een patiënt met insulinoom.
  • In a 57-year-old man with symptomatic hypoglycaemias which gave cause to suspect an insulinoma, normal insulin levels were initially found.
  • Scans revealed an abnormality in the pancreas.
  • After surgical removal of the insulin-producing tumour the patient made a quick recovery.
  • The diagnosis of organic hyperinsulinaemia is established by demonstrating inappropriately high serum-insulin concentrations during fasting hypoglycaemia.
  • This new highly-specific insulin assay has no cross-reactivity with pro-insulin, which is often produced disproportionately more by an insulinoma.
  • As a result of this false-normal insulin values are found.
  • Therefore new normative values are needed for the newer insulin assays when diagnosing an insulin-producing islet cell tumour.
  • Pro-insulin and C-peptide assays may play a useful role in this.
  • [MeSH-major] Hyperinsulinism / etiology. Hypoglycemia / etiology. Insulin / blood. Insulinoma / diagnosis. Pancreatic Neoplasms / diagnosis

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  • (PMID = 15884409.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Blood Glucose; 0 / Insulin
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63. Grant CS: Insulinoma. Best Pract Res Clin Gastroenterol; 2005 Oct;19(5):783-98
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Insulinoma.
  • Although rare, insulinomas are the most common functioning islet cell tumour of the pancreas.
  • Several options are available for imaging and localizing these tumours including ultrasonography, computed tomography, and intra-arterial calcium stimulation with venous sampling.
  • The tumours are usually small, single, benign, well-circumscribed, and evenly distributed throughout the pancreas.
  • This tumour may be a part of the multiple endocrine neoplasia type 1 (MEN-1) syndrome, in which case the tumours are almost always multiple.
  • Surgical treatment is the only curative method, traditionally accomplished with enucleation or partial pancreatic resection.
  • Patients are almost invariably cured lifelong with complete excision of a benign insulinoma.
  • The most recent developments in this area are the recognition of noninsulinoma pancreatogenous hypoglycemia syndrome as a cause of organic hypoglycemia, and the development of laparoscopic techniques to excise these tumours.
  • [MeSH-major] Insulinoma / diagnosis. Insulinoma / surgery. Pancreatectomy / methods. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Aged. Aged, 80 and over. Biopsy, Needle. Endosonography / methods. Female. Humans. Immunohistochemistry. Incidence. Male. Middle Aged. Neoplasm Staging. Phlebography / methods. Prognosis. Rare Diseases. Risk Assessment. Sex Distribution. Survival Rate. Tomography, X-Ray Computed / methods. Treatment Outcome

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  • (PMID = 16253900.001).
  • [ISSN] 1521-6918
  • [Journal-full-title] Best practice & research. Clinical gastroenterology
  • [ISO-abbreviation] Best Pract Res Clin Gastroenterol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 52
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64. Owecki M, Sowiński J: [Successful pharmacological treatment of hyperinsulinemic hypoglycemia with verapamil and amlodipine--case report]. Pol Merkur Lekarski; 2005 Aug;19(110):196-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • In view of the clinical picture (Whipple's triad) a suspicion of hypoglycemia due to an insulinoma of the pancreas aroused.
  • The test was terminated after 22 hours with a glucose concentration of 2.0 mmol/l (36 mg/dl) and an insulin level of 16.19 microU/ml.
  • No visual diagnostic was performed due to the lack of the patient's consent, thus no diagnosis of a tumor of the pancreas could be established.
  • Their efficacy in the medical treatment of insulinoma requires further research.
  • [MeSH-major] Amlodipine / therapeutic use. Hyperinsulinism / complications. Hypoglycemia / drug therapy. Insulinoma / complications. Pancreatic Neoplasms / complications. Verapamil / therapeutic use

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  • (PMID = 16245433.001).
  • [ISSN] 1426-9686
  • [Journal-full-title] Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
  • [ISO-abbreviation] Pol. Merkur. Lekarski
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Calcium Channel Blockers; 1J444QC288 / Amlodipine; CJ0O37KU29 / Verapamil
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65. Meier JJ, Menge BA, Breuer TG, Müller CA, Tannapfel A, Uhl W, Schmidt WE, Schrader H: Functional assessment of pancreatic beta-cell area in humans. Diabetes; 2009 Jul;58(7):1595-603
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  • [Title] Functional assessment of pancreatic beta-cell area in humans.
  • OBJECTIVE: beta-Cell mass declines progressively during the course of diabetes, and various antidiabetic treatment regimens have been suggested to modulate beta-cell mass.
  • However, imaging methods allowing the monitoring of changes in beta-cell mass in vivo have not yet become available.
  • We address whether pancreatic beta-cell area can be assessed by functional test of insulin secretion in humans.
  • RESEARCH DESIGN AND METHODS: A total of 33 patients with chronic pancreatitis (n = 17), benign pancreatic adenomas (n = 13), and tumors of the ampulla of Vater (n = 3) at various stages of glucose tolerance were examined with an oral glucose load before undergoing pancreatic surgery.
  • Indexes of insulin secretion were calculated and compared with the fractional beta-cell area of the pancreas.
  • RESULTS: beta-Cell area was related to fasting glucose concentrations in an inverse linear fashion (r = -0.53, P = 0.0014) and to 120-min postchallenge glycemia in an inverse exponential fashion (r = -0.89).
  • beta-Cell area was best predicted by a C-peptide-to-glucose ratio determined 15 min after the glucose drink (r = 0.72, P < 0.0001).
  • Homeostasis model assessment (HOMA) beta-cell function was unrelated to beta-cell area.
  • CONCLUSIONS: Glucose control is closely related to pancreatic beta-cell area in humans.
  • A C-peptide-to-glucose ratio after oral glucose ingestion appears to better predict beta-cell area than fasting measures, such as the HOMA index.
  • [MeSH-major] Adenoma / pathology. Insulin-Secreting Cells / physiology. Pancreatic Neoplasms / pathology. Pancreatitis, Chronic / pathology
  • [MeSH-minor] Blood Glucose / metabolism. C-Peptide / blood. Diabetes Mellitus / blood. Diabetes Mellitus / pathology. Fasting. Female. Hair Cells, Ampulla / pathology. Humans. Insulin / blood. Male

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  • (PMID = 19509022.001).
  • [ISSN] 1939-327X
  • [Journal-full-title] Diabetes
  • [ISO-abbreviation] Diabetes
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Blood Glucose; 0 / C-Peptide; 0 / Insulin
  • [Other-IDs] NLM/ PMC2699865
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66. Zhang TP, Zhao YP, Cong L, Liao Q, Dai MH, Guo JC: [Noninvasive examinations for localization of insulinoma]. Zhonghua Wai Ke Za Zhi; 2009 Sep 15;47(18):1365-7
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  • [Title] [Noninvasive examinations for localization of insulinoma].
  • OBJECTIVE: To investigate the value of the noninvasive examinations for localization of insulinoma.
  • METHODS: The clinical materials of 88 cases of insulinoma treated in Peking Union Medical College Hospital between January 2005 and November 2008 were analyzed retrospectively.
  • RESULTS: The positive rates for localization were 19.3% (17/88), 52.4% (11/21), 95.5% (64/67), 1/6, 30.0% (6/20), 83.9% (26/31), 8/8 and 5/5 respectively in transabdominal ultrasound, enhanced CT, multislice spiral CT pancreatic perfusion, MRI, somatostatin receptor scintigraphy, endoscopic ultrasound, laparoscopic ultrasound and intraoperative ultrasound.
  • Thirty-one multiple tumors in 8 patients were resected.
  • The positive rates of locating the multiple insulinomas of multislice spiral CT pancreatic perfusion and Intraoperative Ultrasound were 48.4% (15/31) and 100% (14/14) respectively.
  • CONCLUSIONS: The locating diagnosis of insulinoma has came to noninvasive examination era.
  • Multislice spiral CT pancreatic perfusion is the first choice for localization.
  • Intraoperative ultrasound might play an important role in locating tumors for patients with multiple insulinomas.
  • [MeSH-major] Insulinoma / diagnosis. Pancreatic Neoplasms / diagnosis

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  • (PMID = 20092767.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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67. Diaz AG, Herrera J, López M, Puchulu FM, Ferraina P, Bruno OD: Insulinoma associated with pregnancy. Fertil Steril; 2008 Jul;90(1):199.e1-4
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  • [Title] Insulinoma associated with pregnancy.
  • OBJECTIVE: To report three cases of insulinoma associated with pregnancy.
  • SETTING: Divisions of Endocrinology and Gastroenterologic Surgery, Hospital de Clínicas, University of Buenos Aires, Argentina.
  • PATIENT(S): Three patients with hypoglycemic signs due to insulinoma appearing during pregnancy or shortly after delivery.
  • INTERVENTION(S): Laparoscopic excision of insulinoma in two and laparotomy in one of the patients were performed after the end of their pregnancies.
  • MAIN OUTCOME MEASURE(S): Disappearance of hypoglycemic crises and histologic proof of insulinomas.
  • CONCLUSION(S): Insulinoma is often not suspected during the first trimester of pregnancy because signs resemble episodes of hypotension or emesis.
  • Later, with the increase in insulin resistance, symptoms subside.
  • [MeSH-major] Hypoglycemia / etiology. Insulinoma / diagnosis. Pancreatic Neoplasms / diagnosis. Pregnancy Complications, Neoplastic / diagnosis


68. Hrasćan R, Pećina-Slaus N, Martić TN, Colić JF, Gall-Troselj K, Pavelić K, Karapandza N: Analysis of selected genes in neuroendocrine tumours: insulinomas and phaeochromocytomas. J Neuroendocrinol; 2008 Aug;20(8):1015-22
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  • [Title] Analysis of selected genes in neuroendocrine tumours: insulinomas and phaeochromocytomas.
  • Insulinomas and phaeochromocytomas are neuroendocrine tumours that may be either sporadic or manifestation of a familial cancer syndromes and are both derived from the neural crest.
  • In the present study, gene components of different signalling pathways were investigated in sporadic human insulinomas and phaeochromocytomas to identify the responsible candidates.
  • Twenty-two sporadic insulinomas and 15 phaeochromocytomas were analysed by the polymerase chain reaction using restriction fragment length polymorphism or dinucleotide repeat polymorphism methods.
  • The results of our analysis demonstrate that the most frequent changes were point mutations of k-ras: 23% of insulinomas and 62% of phaeochromocytomas harboured k-ras mutations.
  • Only one insulinoma showed LOH of NF1, and another showed LOH of p53.
  • Allelic loss of BRCA1 was detected in two insulinomas, and of nm23-H1 in another insulinoma.
  • Allelic losses of the SDHB gene were present in two phaeochromocytoma and one insulinoma cases and allelic losses of SDHD were present in one phaeochromocytoma case.
  • The changes observed in phaeochromocytomas were more homogenous and confined to k-ras and ret oncogenes, whereas insulinomas showed more heterogenic situation.
  • Our findings may contribute to a better understanding of the genetic profile of neuroendocrine tumours.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Insulinoma / genetics. Neuroendocrine Tumors / genetics. Pancreatic Neoplasms / genetics. Pheochromocytoma / genetics
  • [MeSH-minor] Adult. Aged. DNA Mutational Analysis. Female. Gene Expression Profiling. Gene Expression Regulation, Neoplastic. Genes, Tumor Suppressor. Humans. Loss of Heterozygosity. Male. Middle Aged. Young Adult


69. Blasetti A, Di Pietro L, di Corcia G, Franzoni E, Chiarelli F, Verrotti A: Can insulinoma cause generalised epilepsy? J Pediatr Endocrinol Metab; 2007 Jul;20(7):837-40
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  • [Title] Can insulinoma cause generalised epilepsy?
  • Insulinoma is a common cause of seizures due to recurrent hypoglycemic crises.
  • We describe a previously healthy 17 year-old girl who became epileptic after the onset of insulinoma with persistent seizures after surgical removal of the tumour.
  • Insulinoma must be taken into account for differential diagnosis with convulsions of unknown origin, and even after metabolic normalization it may cause epilepsy.
  • [MeSH-major] Epilepsy / etiology. Insulinoma / complications. Pancreatic Neoplasms / complications

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  • (PMID = 17849747.001).
  • [ISSN] 0334-018X
  • [Journal-full-title] Journal of pediatric endocrinology & metabolism : JPEM
  • [ISO-abbreviation] J. Pediatr. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Anticonvulsants; 0H73WJJ391 / topiramate; 30237-26-4 / Fructose
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70. Glading AJ, Ginsberg MH: Rap1 and its effector KRIT1/CCM1 regulate beta-catenin signaling. Dis Model Mech; 2010 Jan-Feb;3(1-2):73-83
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  • [Title] Rap1 and its effector KRIT1/CCM1 regulate beta-catenin signaling.
  • KRIT1, also called CCM1, is a member of a multiprotein complex that contains the products of the CCM2 and PDCD10 (also known as CCM3) loci.
  • KRIT1 mediates the stabilization of beta-catenin-containing endothelial cell-cell junctions downstream of the Rap1 GTPase.
  • Here, we report that Rap1 and KRIT1 are negative regulators of canonical beta-catenin signaling in mice and that hemizygous Krit1 deficiency exacerbates beta-catenin-driven pathologies.
  • Depletion of endothelial KRIT1 caused beta-catenin to dissociate from vascular endothelial (VE)-cadherin and to accumulate in the nucleus with consequent increases in beta-catenin-dependent transcription.
  • Activation of Rap1 inhibited beta-catenin-dependent transcription in confluent endothelial cells; this effect required the presence of intact cell-cell junctions and KRIT1.
  • These effects of KRIT1 were not limited to endothelial cells; the KRIT1 protein was expressed widely and its depletion increased beta-catenin signaling in epithelial cells.
  • Moreover, a reduction in KRIT1 expression also increased beta-catenin signaling in vivo.
  • Hemizygous deficiency of Krit1 resulted in a ~1.5-fold increase in intestinal polyps in the Apc(Min/+) mouse, which was associated with increased beta-catenin-driven transcription.
  • Thus, KRIT1 regulates beta-catenin signaling, and Krit1(+/-) mice are more susceptible to beta-catenin-driven intestinal adenomas.

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  • (PMID = 20007487.001).
  • [ISSN] 1754-8411
  • [Journal-full-title] Disease models & mechanisms
  • [ISO-abbreviation] Dis Model Mech
  • [Language] ENG
  • [Grant] United States / NHLBI NIH HHS / HL / HL31950; United States / NIAMS NIH HHS / AR / R01 AR027214; United States / NIAMS NIH HHS / AR / AR27214; United States / NHLBI NIH HHS / HL / P01 HL031950; United States / NIAMS NIH HHS / AR / R37 AR027214; United States / NHLBI NIH HHS / HL / P01 HL078784; United States / NHLBI NIH HHS / HL / HL078784
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Cadherins; 0 / Krit1 protein, mouse; 0 / Microtubule-Associated Proteins; 0 / Proto-Oncogene Proteins; 0 / beta Catenin; EC 3.6.5.2 / rap1 GTP-Binding Proteins
  • [Other-IDs] NLM/ PMC2806902
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71. Jonkers YM, Ramaekers FC, Speel EJ: Molecular alterations during insulinoma tumorigenesis. Biochim Biophys Acta; 2007 Jun;1775(2):313-32
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  • [Title] Molecular alterations during insulinoma tumorigenesis.
  • Insulinomas are the most common functioning endocrine pancreatic tumors (EPTs).
  • They present with clinical symptoms as a consequence of hypoglycemia induced by inappropriate insulin secretion.
  • The etiology of these tumors is poorly understood.
  • Some tumors may harbor MEN1 gene mutations, the susceptibility gene of the multiple endocrine neoplasia type I syndrome, but most cases show wildtype MEN1.
  • Currently, no reliable clinical tests are available to differentiate benign from malignant tumors.
  • Approximately 30% of the tumors are unresectable, and they often show different growth rates, which hampers treatment.
  • Therefore, a better understanding of the molecular processes underlying the development and progression of insulinomas is required to improve diagnosis, prognosis and therapy.
  • Here we summarize the progress that has been made in insulinoma research in the past decade.
  • We describe the clinical detection, classification and treatment of these tumors, and review the multiplicity of molecular and genetic studies that investigated tumor development and progression using either primary tumors, transgenic mouse models or tumor-derived cell lines.
  • The identification of many interactors of the MEN1 gene product menin, as well as recurrent chromosomal abnormalities that pinpoint candidate genes of interest will likely result in a better understanding of the molecular pathways involved in insulinoma tumorigenesis.
  • [MeSH-major] Insulinoma / genetics. Pancreatic Neoplasms / genetics
  • [MeSH-minor] Genetic Markers. Humans. Neoplasm Invasiveness. Neoplasm Metastasis / genetics. Neoplasm Metastasis / pathology. Signal Transduction / physiology

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  • (PMID = 17572302.001).
  • [ISSN] 0006-3002
  • [Journal-full-title] Biochimica et biophysica acta
  • [ISO-abbreviation] Biochim. Biophys. Acta
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Genetic Markers
  • [Number-of-references] 182
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72. Sweet MP, Izumisato Y, Way LW, Clark OH, Masharani U, Duh QY: Laparoscopic enucleation of insulinomas. Arch Surg; 2007 Dec;142(12):1202-4; discussion 1205
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  • [Title] Laparoscopic enucleation of insulinomas.
  • HYPOTHESIS: Laparoscopic enucleation of insulinomas is safe and effective and is associated with a short hospital stay.
  • PATIENTS: Nine patients with insulinomas that were thought to be suitable for laparoscopic enucleation.
  • INTERVENTION: Laparoscopic enucleation of solitary insulinomas of the pancreas.
  • RESULTS: Seven of 9 patients had curative laparoscopic enucleations of insulinomas.
  • Computed tomography (CT) localized the tumor in 5 of 9 patients; laparoscopic enucleation was successful in all 5.
  • Postoperative pancreatic fistulas occurred in 7 of 9 patients, but they caused little morbidity.
  • Pancreatic fistulas were common, but they resolved spontaneously and produced little morbidity.
  • [MeSH-major] Insulinoma / surgery. Laparoscopy. Pancreatectomy. Pancreatic Neoplasms / surgery

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  • (PMID = 18086988.001).
  • [ISSN] 1538-3644
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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73. Vaidakis D, Karoubalis J, Pappa T, Piaditis G, Zografos GN: Pancreatic insulinoma: current issues and trends. Hepatobiliary Pancreat Dis Int; 2010 Jun;9(3):234-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pancreatic insulinoma: current issues and trends.
  • BACKGROUND: Although insulinomas are very rare tumors, they are the most common pancreatic neuroendocrine neoplasms.
  • The malignancy of insulinomas is difficult to be predicted on the basis of their histological features, and the current WHO classification has been re-evaluated.
  • This review aimed to summarize classical knowledge with current trends in the diagnosis and treatment of insulinomas.
  • DATA SOURCES: A Medline search using terms "insulinoma", "treatment" and "neuroendocrine tumors" was conducted.
  • RESULTS: Surgery is the treatment of choice for insulinoma and has an extremely high success rate.
  • Many methods exist for localization of an insulinoma and can be invasive and non-invasive.
  • The combination of biphasic thin section helical CT and endoscopic ultrasonography (EUS) has an almost 100% sensitivity in localizing insulinomas.
  • Laparoscopic ultrasound is mandatory to localize intraoperatively these tumors.
  • CONCLUSION: Laparoscopic resection for benign insulinomas is the procedure of choice, whereas pancreatectomy is reserved for large, potentially malignant tumors.
  • [MeSH-major] Diagnostic Imaging / trends. Digestive System Surgical Procedures / trends. Insulinoma. Pancreatic Neoplasms

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  • (PMID = 20525548.001).
  • [ISSN] 1499-3872
  • [Journal-full-title] Hepatobiliary & pancreatic diseases international : HBPD INT
  • [ISO-abbreviation] HBPD INT
  • [Language] eng
  • [Publication-type] Historical Article; Journal Article; Review
  • [Publication-country] China
  • [Number-of-references] 80
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74. Ozkaya M, Yuzbasioglu MF, Koruk I, Cakal E, Sahin M, Cakal B: Preoperative detection of insulinomas: two case reports. Cases J; 2008;1(1):362

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Preoperative detection of insulinomas: two case reports.
  • BACKGROUND: Insulinoma is the most common endocrine tumor of the pancreas.
  • Accurate preoperative detection and localization of insulinomas is essential for the appropriate selection of candidates for surgery.
  • We present two cases with benign pancreatic insulinoma.
  • CASE PRESENTATION: Preoperative evaluation for patients with suspected insulinomas has been controversial.
  • CONCLUSION: We have detected the insulinomas with EUS before surgery in our patients but other imaging modalities did not help us for localization of them.
  • We reviewed here the different modalities for preoperative localization of insulinoma.

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  • [Cites] AJR Am J Roentgenol. 2003 Oct;181(4):987-92 [14500214.001]
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  • (PMID = 19040758.001).
  • [ISSN] 1757-1626
  • [Journal-full-title] Cases journal
  • [ISO-abbreviation] Cases J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2633341
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75. Tucker ON, Crotty PL, Conlon KC: The management of insulinoma. Br J Surg; 2006 Mar;93(3):264-75
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The management of insulinoma.
  • BACKGROUND: Insulinomas are rare tumours.
  • METHODS: An electronic search of the Medline, Embase and Cochrane databases was undertaken for articles published between January 1966 and June 2005 on the history, presentation, clinical evaluation, use of imaging techniques for tumour localization and operative management of insulinoma.
  • RESULTS AND CONCLUSION: Most insulinomas are intrapancreatic, benign and solitary.
  • Intraoperative ultrasonography can be combined with other preoperative imaging modalities to improve tumour detection.
  • In the absence of preoperative localization and intraoperative detection of an insulinoma, blind pancreatic resection is not recommended.
  • [MeSH-major] Hypoglycemia / etiology. Insulinoma. Pancreatic Neoplasms
  • [MeSH-minor] Female. Humans. Insulin / secretion. Male. Pancreatectomy / methods. Proto-Oncogene Proteins / genetics

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  • [Copyright] Copyright (c) 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
  • (PMID = 16498592.001).
  • [ISSN] 0007-1323
  • [Journal-full-title] The British journal of surgery
  • [ISO-abbreviation] Br J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Insulin; 0 / MEN1 protein, human; 0 / Proto-Oncogene Proteins
  • [Number-of-references] 102
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76. Bright E, Garcea G, Ong SL, Madira W, Berry DP, Dennison AR: An unusual case of concurrent insulinoma and nesidioblastosis. JOP; 2008;9(5):649-53
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] An unusual case of concurrent insulinoma and nesidioblastosis.
  • CONTEXT: Endogenous hyperinsulinaemic hypoglycaemia in adults is most commonly caused by an insulinoma.
  • To the best of our knowledge the presence of both insulinoma and nesidioblastosis has not been reported before.
  • CASE REPORT: We report a case of a 35-year-old female presenting with neuroglycaemic symptoms.
  • However, a grossly elevated insulin level within the splenic vein on a second set of venous sampling produced a high index of suspicion for the presence of an insulinoma.
  • At surgical exploration both an insulinoma and nesidioblastosis were identified and confirmed by histological examination.
  • CONCLUSION: We report an even rarer entity of concurrent insulinoma and nesidioblastosis.
  • [MeSH-major] Insulinoma / complications. Nesidioblastosis / complications. Pancreatic Neoplasms / complications

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  • (PMID = 18762698.001).
  • [ISSN] 1590-8577
  • [Journal-full-title] JOP : Journal of the pancreas
  • [ISO-abbreviation] JOP
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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77. Isla A, Arbuckle JD, Kekis PB, Lim A, Jackson JE, Todd JF, Lynn J: Laparoscopic management of insulinomas. Br J Surg; 2009 Feb;96(2):185-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic management of insulinomas.
  • BACKGROUND: Conventional surgical management of insulinomas involves an open technique.
  • This retrospective study evaluated the laparoscopic management of pancreatic insulinomas.
  • METHODS: Between December 2000 and March 2007, 23 patients were referred for consideration of laparoscopic insulinoma resection.
  • All surgery was performed by one experienced pancreatic surgeon.
  • All had single tumours, five in the head, nine in the body and seven in the tail of the pancreas.
  • One conversion to open operation was performed in a patient with an insulinoma in the head of the pancreas who had dense adhesions resulting from pancreatitis.
  • Three patients developed a postoperative pancreatic fistula.
  • CONCLUSION: Laparoscopic management of insulinomas is feasible and safe.
  • [MeSH-major] Insulinoma / surgery. Laparoscopy. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Blood Loss, Surgical. Feasibility Studies. Female. Humans. Male. Middle Aged. Pancreatectomy / methods. Pancreatic Fistula / etiology. Postoperative Complications / etiology. Retrospective Studies. Treatment Outcome. Young Adult

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  • (PMID = 19160363.001).
  • [ISSN] 1365-2168
  • [Journal-full-title] The British journal of surgery
  • [ISO-abbreviation] Br J Surg
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] England
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78. Besemer B, Müssig K: Insulinoma in pregnancy. Exp Clin Endocrinol Diabetes; 2010 Jan;118(1):9-18
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Insulinoma in pregnancy.
  • Insulinomas are rare, mostly benign neuroendocrine tumours with an incidence of approximately four cases per million person per year.
  • Only isolated case reports of insulinomas occurring in pregnancy have been documented.
  • Clinical signs and symptoms of insulinoma appear to be attenuated and, in some cases, even masked by pregnancy.
  • Therefore, in the present overview of insulinomas occurring during pregnancy, special attention is paid to potential factors contributing to the altered insulin response during pregnancy.
  • [MeSH-major] Insulinoma. Pancreatic Neoplasms. Pregnancy Complications, Neoplastic
  • [MeSH-minor] Blood Glucose / analysis. Diagnosis, Differential. Female. Humans. Insulin Resistance. Postpartum Period / blood. Pregnancy. Treatment Outcome

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  • [Copyright] J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart, New York.
  • (PMID = 19373751.001).
  • [ISSN] 1439-3646
  • [Journal-full-title] Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
  • [ISO-abbreviation] Exp. Clin. Endocrinol. Diabetes
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Blood Glucose
  • [Number-of-references] 50
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79. Maestri M, Monzani F, Bonanni E, Di Coscio E, Cignoni F, Dardano A, Iudice A, Murri L: Insulinoma presenting as idiopathic hypersomnia. Neurol Sci; 2010 Jun;31(3):349-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Insulinoma presenting as idiopathic hypersomnia.
  • We report the case of a 32-year-old woman with a history of increased sleep need and difficulty waking up; the diagnosis of idiopathic hypersomnia was hypothesized.
  • The diagnosis of insulinoma was then assumed; CT scan showed a hypodense mass into the pancreatic tail, and a partial pancreasectomy was performed.
  • The described symptoms disappeared, and 5 years later the findings of a complete clinical and neurophysiological examination were negative.
  • The clinical picture of insulinoma presenting with paroxysmal disorders has been previously described; however, whereas hypersomnia is uncommon, in the current case it represents the main symptom.
  • [MeSH-major] Hypersomnolence, Idiopathic / diagnosis. Insulinoma / diagnosis
  • [MeSH-minor] Adult. Brain / physiopathology. Diagnosis, Differential. Electroencephalography. Female. Humans. Pancreas / diagnostic imaging. Pancreas / surgery. Polysomnography / methods. Radiography. Sleep / physiology. Video Recording / methods

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  • [Cites] Neurology. 2001 Mar 27;56(6):817-8 [11274331.001]
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  • (PMID = 20119740.001).
  • [ISSN] 1590-3478
  • [Journal-full-title] Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
  • [ISO-abbreviation] Neurol. Sci.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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80. Atwell TD, Lloyd RV, Nagorney DM, Fidler JL, Andrews JC, Reading CC: Peritumoral steatosis associated with insulinomas: appearance at imaging. Abdom Imaging; 2008 Sep-Oct;33(5):571-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Peritumoral steatosis associated with insulinomas: appearance at imaging.
  • We report three patients with insulinoma tumors and distinct peritumoral steatosis, well demonstrated with several imaging modalities.
  • [MeSH-major] Fatty Liver / diagnosis. Insulinoma / diagnosis. Liver Neoplasms / diagnosis. Pancreatic Neoplasms / diagnosis

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  • (PMID = 18506503.001).
  • [ISSN] 1432-0509
  • [Journal-full-title] Abdominal imaging
  • [ISO-abbreviation] Abdom Imaging
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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81. Suzuki K, Miyamoto M, Miyamoto T, Hirata K: Insulinoma with early-morning abnormal behavior. Intern Med; 2007;46(7):405-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Insulinoma with early-morning abnormal behavior.
  • We report a 65-year-old man with insulinoma who initially developed stereotypical behaviors and then progressed to more complex behaviors occurring early in the morning.
  • Insulinoma was diagnosed based on fasting blood glucose level of 15 mg/dl, high fasting immunoreactive insulin/blood glucose ratio (more than 0.3), and a tumor in the pancreas head by abdominal CT.
  • Hypoglycemia caused by insulinoma should be considered as one of the mechanisms underlying abnormal nocturnal behaviors since the symptoms are very similar to those of sleep-related epilepsy, parasomnia, and night delirium.
  • [MeSH-major] Behavioral Symptoms / etiology. Hypoglycemia / diagnosis. Hypoglycemia / psychology. Insulinoma / diagnosis. Pancreatic Neoplasms / diagnosis

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  • (PMID = 17409607.001).
  • [ISSN] 1349-7235
  • [Journal-full-title] Internal medicine (Tokyo, Japan)
  • [ISO-abbreviation] Intern. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 9PHQ9Y1OLM / Prednisolone; IY9XDZ35W2 / Glucose
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82. Ahn J, Lee SE, Choi YS, Tan AH, Kim J, Chung YJ: Overtly manifested diabetes mellitus after resection of insulinoma. Intern Med; 2009;48(24):2105-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Overtly manifested diabetes mellitus after resection of insulinoma.
  • Insulinoma is the most common cause of endogenous hyperinsulinemic hypoglycemia in adults.
  • However, the coincidence of insulinoma and diabetes is extremely uncommon.
  • We describe a rare, but very interesting case of diabetes mellitus which was masked by insulinoma and was overtly manifest after the removal of the insulinoma.
  • [MeSH-major] Diabetes Complications. Insulinoma / complications. Insulinoma / surgery. Pancreatic Neoplasms / complications. Pancreatic Neoplasms / surgery

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  • (PMID = 20009401.001).
  • [ISSN] 1349-7235
  • [Journal-full-title] Internal medicine (Tokyo, Japan)
  • [ISO-abbreviation] Intern. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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83. Gnacńska M, Lewczuk A, Sworczak K: [Insulinoma misdiagnosed and treated as epilepsy]. Pol Merkur Lekarski; 2008 Mar;24(141):251-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Insulinoma misdiagnosed and treated as epilepsy].
  • [Transliterated title] Wyspiak trzustki mylnie rozpoznany i leczony jako padaczka--opis przypadku.
  • Although insulinoma constitutes almost 90% of neuroendocrine tumors localized in the pancreas, it is a rare disease.
  • Quite commonly prior to the diagnosis there is a history of several years and misdiagnosis as neurological or cardiological disease is not infrequent.
  • Increase in body weight, typical for insulinoma, was also observed.
  • The patient was hospitalized twice in Pediatric Department and although hypoglycemia was observed, no additional testing was performed to exclude insulinoma; reported symptoms and abnormalities in EEG recording after provocation resulted in diagnosis and treatment of epilepsy.
  • During hospitalization in the Department of Endocrinology fasting test was performed, which revealed inadequately high insulin level with glucose level of 41 mg% and signs of neuroglycopenia.
  • The image of pancreas was normal in the acquired abdominal ultrasound and in CT a tumor was found in the tail of pancreas.
  • [MeSH-major] Epilepsy / diagnosis. Insulinoma / diagnosis. Pancreatic Neoplasms / diagnosis

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  • (PMID = 18634294.001).
  • [ISSN] 1426-9686
  • [Journal-full-title] Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
  • [ISO-abbreviation] Pol. Merkur. Lekarski
  • [Language] pol
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Poland
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84. Schraibman V, Goldenberg A, de Matos Farah JF, Apodaca FR, Goldman S, Lobo EJ: Laparoscopic enucleation of pancreatic insulinomas. J Laparoendosc Adv Surg Tech A; 2007 Aug;17(4):399-401
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic enucleation of pancreatic insulinomas.
  • Insulinomas are rare endocrine pancreatic tumors whose incidence has been increasing in recent years owing to early detection by clinical and radiologic, such as remote neural monitoring, computed tomography (CT), and ultrasound (US) findings.
  • The aim of this paper was to present 5 patients who were diagnosed with pancreatic insulinomas that were treated by laparoscopic resection.
  • Five (5) patients, ranging from 14 to 45 years and presenting with classical Whipple Triad, had lesions ranging from 1.5 to 2.5 cm by CT (body and tail of the pancreas), which were subsequently diagnosed as insulinomas.
  • The laparoscopic resection of pancreatic insulinomas is a reliable procedure for superficial lesions in the body and tail of the pancreas.
  • [MeSH-major] Insulinoma / surgery. Laparoscopy. Pancreatic Neoplasms / surgery

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  • (PMID = 17705715.001).
  • [ISSN] 1092-6429
  • [Journal-full-title] Journal of laparoendoscopic & advanced surgical techniques. Part A
  • [ISO-abbreviation] J Laparoendosc Adv Surg Tech A
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Blood Glucose
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85. Karachaliou F, Vlachopapadopoulou E, Kaldrymidis P, Simatos G, Zacharea M, Spanidou-Karvouni E, Michalacos S, Voros D: Malignant insulinoma in childhood. J Pediatr Endocrinol Metab; 2006 May;19(5):757-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant insulinoma in childhood.
  • Pancreatic tumors constitute a rare surgical problem in infancy and childhood.
  • Insulinomas are rare in all age groups with an estimated incidence of one per 250,000 person-years and even rarer in childhood.
  • We report a 10 year-old girl with malignant insulinoma.
  • MRI of the abdomen revealed a mass at the tail of the pancreas.
  • Histological examination showed malignant insulinoma with peripancreatic lymph node metastases.
  • Treatment with octreotide was started and the disease is stable after 12 months of therapy.
  • [MeSH-major] Insulinoma / pathology. Pancreatic Neoplasms / pathology

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  • (PMID = 16789643.001).
  • [ISSN] 0334-018X
  • [Journal-full-title] Journal of pediatric endocrinology & metabolism : JPEM
  • [ISO-abbreviation] J. Pediatr. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; RWM8CCW8GP / Octreotide
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86. McAuley G, Delaney H, Colville J, Lyburn I, Worsley D, Govender P, Torreggiani WC: Multimodality preoperative imaging of pancreatic insulinomas. Clin Radiol; 2005 Oct;60(10):1039-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Multimodality preoperative imaging of pancreatic insulinomas.
  • Pancreatic insulinomas are rare tumours of the islet cells of the pancreas, which account for the majority of functional neuroendocrine tumours of the pancreas.
  • Insulinomas are usually solitary, and the vast majority are intra-pancreatic in location.
  • Insulinomas continue to pose a diagnostic challenge to physicians, surgeons and radiologists alike.
  • The role of imaging is to detect and provide precise anatomical localization and staging of tumours prior to surgery.
  • In this review, we describe the current "state of the art" imaging protocols that may be used in the preoperative localization of insulinomas.
  • [MeSH-major] Insulinoma / diagnosis. Pancreatic Neoplasms / diagnosis

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  • [CommentIn] Clin Radiol. 2006 Mar;61(3):299 [16488216.001]
  • [CommentIn] Clin Radiol. 2006 Mar;61(3):299 [16488215.001]
  • (PMID = 16179163.001).
  • [ISSN] 0009-9260
  • [Journal-full-title] Clinical radiology
  • [ISO-abbreviation] Clin Radiol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 31
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87. Rodriguez MC, Nair G: Insulinoma: diagnosis and localization procedures. J Ark Med Soc; 2006 Mar;102(9):251-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Insulinoma: diagnosis and localization procedures.
  • A supervised 72-hour fasting test showed a plasma glucose of 30 mg/dl, insulin of 11 ulU/ml, proinsulin of 16.8 pmol/L and C-peptide 2.3 ng/ml after 16 hours of fasting.
  • MRI showed a 12mm mass in the head of the pancreas.
  • The tumor was resected and pathology was consistent with an insulinoma.
  • We reviewed here the different modalities for preoperative localization of insulinoma.
  • [MeSH-major] Insulinoma / diagnosis. Pancreatic Neoplasms / diagnosis

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  • (PMID = 16562763.001).
  • [ISSN] 0004-1858
  • [Journal-full-title] The Journal of the Arkansas Medical Society
  • [ISO-abbreviation] J Ark Med Soc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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88. Ding Y, Wang S, Liu J, Yang Y, Liu Z, Li J, Zhang B, Chen Y, Ding M: Neuropsychiatric profiles of patients with insulinomas. Eur Neurol; 2010;63(1):48-51
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  • [Title] Neuropsychiatric profiles of patients with insulinomas.
  • BACKGROUND/AIMS: Insulinoma is a rare and potentially curable disease.
  • It is often misdiagnosed as neurological or psychiatric disorder.
  • This study was performed to characterize the neuropsychiatric symptoms (PNS) of the patients with insulinoma from a regional clinical center.
  • METHODS: All medical records of the patients with histopathologically identified insulinoma were reviewed during the period from 1998 to 2008.
  • A case-control analysis was performed to compare the demographic data, details of clinical presentation, biochemical findings, tumor localization, and intraoperative findings between the patients with and without a prior misdiagnosis.
  • RESULTS: Among 42 patients with insulinoma, 25 patients with PNS were initially misdiagnosed as having a neurological or psychiatric disease, while 17 patients with no PNS were correctly diagnosed.
  • CONCLUSIONS: Episodic hypoglycemia induced by insulinoma can greatly mimic neurological and psychiatric presentation.
  • [MeSH-major] Insulinoma / diagnosis. Mental Disorders / diagnosis. Pancreatic Neoplasms / diagnosis

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  • [Copyright] Copyright 2009 S. Karger AG, Basel.
  • (PMID = 20029216.001).
  • [ISSN] 1421-9913
  • [Journal-full-title] European neurology
  • [ISO-abbreviation] Eur. Neurol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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89. Hoem D, Jensen D, Steine S, Thorsen TE, Viste A, Molven A: Clinicopathological characteristics and non-adhesive organ culture of insulinomas. Scand J Surg; 2008;97(1):42-9
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  • [Title] Clinicopathological characteristics and non-adhesive organ culture of insulinomas.
  • BACKGROUND AND AIMS: Insulinoma is a very rare type of islet cell tumour, but nevertheless the most common endocrine tumour of the pancreas.
  • We aimed at reviewing our clinical experience with this tumour type and to assess whether organ culture could be obtained from surgically resected insulinoma material.
  • MATERIAL AND METHODS: All patients with insulinomas (6 men and 10 women) referred to Haukeland University Hospital between 1986 and 2006 were included in the study.
  • Imaging and localization of the tumours were performed with intra-operative ultrasonography, endoscopic ultrasonography, CT-scan and/or transcutaneous ultrasonography.
  • For six patients, organ cultures were set up from tumour tissue fragments.
  • RESULTS: The annual incidence of insulinoma was 0.8 per million.
  • The patients generally presented with non-specific, episodic symptoms, which often were mistaken for cardiovascular, neurological or diabetic disease and in some cases delayed the diagnosis with several years.
  • Two patients had diabetes prior to the diagnosis of insulinoma.
  • Intra-operative ultrasonography detected all tumours correctly, whereas 73% were detected by endoscopic ultrasonography and 38% by CT scan.
  • Five insulinomas were located in the head, eight in the body and three in the tail of the pancreas.
  • One tumour was malignant with liver metastases and two patients had tumours defined as borderline.
  • Insulinoma tissue fragments developed into spheroids during the first week of culturing and insulin secretion into the media was demonstrated.
  • CONCLUSIONS: Insulinomas are rare and diagnostically challenging tumours.
  • In organ culture, insulinomas readily form spheroids which may be used to yield insight into beta-cell biology.
  • [MeSH-major] Insulinoma / pathology. Pancreatic Neoplasms / pathology. Tumor Cells, Cultured
  • [MeSH-minor] Adult. Aged. Cell Culture Techniques. Female. Humans. Male. Middle Aged. Norway / epidemiology

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  • (PMID = 18450205.001).
  • [ISSN] 1457-4969
  • [Journal-full-title] Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society
  • [ISO-abbreviation] Scand J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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90. Abboud B, Boujaoude J: Occult sporadic insulinoma: localization and surgical strategy. World J Gastroenterol; 2008 Feb 7;14(5):657-65
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Occult sporadic insulinoma: localization and surgical strategy.
  • Insulinomas continue to pose a diagnostic challenge to physicians, surgeons and radiologists alike.
  • Despite all efforts, an occult insulinoma (occult insulinoma refers to a biochemically proven tumor with indeterminate anatomical site before operation) may still be encountered.
  • New localization preoperative techniques decreases occult cases and the knowledge of the site of the mass before surgery allows to determine whether enucleation of the tumor or pancreatic resection is likely to be required and whether the tumor is amenable to removal via a laparoscopic approach.
  • In absence of preoperative localization and intraoperative detection of an insulinoma, blind pancreatic resection is not recommended.
  • [MeSH-major] Insulinoma / surgery. Insulinoma / ultrasonography. Pancreatic Neoplasms / surgery. Pancreatic Neoplasms / ultrasonography

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  • (PMID = 18205253.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Editorial; Review
  • [Publication-country] China
  • [Number-of-references] 129
  • [Other-IDs] NLM/ PMC2683990
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91. Doi A, Shono T, Nishi M, Furuta H, Sasaki H, Nanjo K: IA-2beta, but not IA-2, is induced by ghrelin and inhibits glucose-stimulated insulin secretion. Proc Natl Acad Sci U S A; 2006 Jan 24;103(4):885-90
SciCrunch. OMIM: Data: Gene Annotation .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] IA-2beta, but not IA-2, is induced by ghrelin and inhibits glucose-stimulated insulin secretion.
  • Ghrelin and the GHS receptor are expressed also in pancreatic islets.
  • We have identified several ghrelin-induced genes by PCR-select subtraction methods, among which is a beta-cell autoantigen for type 1 diabetes, IA-2beta.
  • Administration of ghrelin increased IA-2beta mRNA in mouse brain, pancreas, and insulinoma cell lines (MIN6 and betaTC3).
  • However, the expression of IA-2, another structurally related beta-cell autoantigen, was not induced by ghrelin.
  • Administration of ghrelin or overexpression of IA-2beta, but not overexpression of IA-2, inhibited glucose-stimulated insulin secretion in MIN6 insulinoma cells and, moreover, inhibition of IA-2beta expression by the RNA interference technique ameliorated ghrelin's inhibitory effects on glucose-stimulated insulin secretion.
  • These findings strongly suggest that inhibitory effects of ghrelin on glucose-stimulated insulin secretion are at least partly due to increased expression of IA-2beta induced by ghrelin.
  • Our data demonstrate the link among ghrelin, IA-2beta, and glucose-stimulated insulin secretion.
  • [MeSH-major] Autoantibodies / biosynthesis. Glucose / metabolism. Insulin / secretion. Membrane Proteins / biosynthesis. Peptide Hormones / metabolism. Protein Tyrosine Phosphatases / biosynthesis
  • [MeSH-minor] Animals. Blotting, Northern. Blotting, Western. Cell Line. Cell Line, Tumor. Dose-Response Relationship, Drug. Enzyme-Linked Immunosorbent Assay. Gene Expression Regulation. Ghrelin. Growth Hormone / metabolism. Insulin-Secreting Cells / metabolism. Insulinoma / metabolism. Islets of Langerhans / metabolism. Ligands. Male. Mice. Mice, Inbred C57BL. Phosphorylation. Polymerase Chain Reaction. Protein Tyrosine Phosphatase, Non-Receptor Type 1. RNA Interference. RNA, Messenger / metabolism. RNA, Small Interfering / metabolism. Receptor-Like Protein Tyrosine Phosphatases, Class 8. Reverse Transcriptase Polymerase Chain Reaction. Time Factors

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  • (PMID = 16418280.001).
  • [ISSN] 0027-8424
  • [Journal-full-title] Proceedings of the National Academy of Sciences of the United States of America
  • [ISO-abbreviation] Proc. Natl. Acad. Sci. U.S.A.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Autoantibodies; 0 / Ghrelin; 0 / ICA512 autoantibody; 0 / Insulin; 0 / Ligands; 0 / Membrane Proteins; 0 / Peptide Hormones; 0 / RNA, Messenger; 0 / RNA, Small Interfering; 9002-72-6 / Growth Hormone; EC 3.1.3.48 / PTPRN2 protein, human; EC 3.1.3.48 / Protein Tyrosine Phosphatase, Non-Receptor Type 1; EC 3.1.3.48 / Protein Tyrosine Phosphatases; EC 3.1.3.48 / Receptor-Like Protein Tyrosine Phosphatases, Class 8; IY9XDZ35W2 / Glucose
  • [Other-IDs] NLM/ PMC1347964
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92. Shin JJ, Gorden P, Libutti SK: Insulinoma: pathophysiology, localization and management. Future Oncol; 2010 Feb;6(2):229-37
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  • [Title] Insulinoma: pathophysiology, localization and management.
  • Insulinoma is a rare neuroendocrine tumor that causes oversecretion of insulin and, as a result, patients present with symptoms of hypoglycemia.
  • Fortunately, insulinomas are usually benign and solitary, and surgical cure rates are highly favorable.
  • Most of these tumors occur sporadically, but they can also be associated with multiple endocrine neoplasia type-1 syndrome.
  • When technically feasible, tumor enucleation is the procedure of choice; however, a more formal resection may be necessary for certain tumors.
  • In the age of laparoscopy, the role of laparoscopic surgery in the management of insulinomas is continuing to attract attention.
  • This review will discuss the historical background, pathogenesis, diagnosis, localization and management of insulinomas.
  • [MeSH-major] Insulinoma. Pancreatic Neoplasms

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  • (PMID = 20146582.001).
  • [ISSN] 1744-8301
  • [Journal-full-title] Future oncology (London, England)
  • [ISO-abbreviation] Future Oncol
  • [Language] eng
  • [Grant] United States / Intramural NIH HHS / / Z99 DK999999
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 87
  • [Other-IDs] NLM/ NIHMS410903; NLM/ PMC3498768
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93. Le Berre JP, Bey Boeglin M, Duverger V, Garcia C, Bordier L, Dupuy O, Mayaudon H, Bauduceau B: [Seizure and Bourneville tuberous sclerosis: think about insulinoma]. Rev Med Interne; 2009 Feb;30(2):179-80
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  • [Title] [Seizure and Bourneville tuberous sclerosis: think about insulinoma].
  • [Transliterated title] Crise comitiale et sclérose tubéreuse de Bourneville: penser à l'insulinome.
  • We report a case of a Bourneville tuberous sclerosis in a 41-year-old-man with hypoglycemia leading to seizures, resulting from an insulinoma.


94. Tamagno G, Maffei P, Pasquali C, De Carlo E, Martini C, Mioni R, Crivellaro C, Faggian D, Pedrazzoli S, Sicolo N: Clinical and diagnostic aspects of cystic insulinoma. Scand J Gastroenterol; 2005 Dec;40(12):1497-501
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  • [Title] Clinical and diagnostic aspects of cystic insulinoma.
  • Cystic endocrine tumors of the pancreas rarely occur, and only a few cases of cystic insulinoma have been reported to date.
  • Diagnosis of insulinoma could be difficult if the functional activity is incomplete, possibly leading to blunted symptoms of hypoglycemia and failure in the laboratory to provide evidence of hyperinsulinemia.
  • We report a clinical case of cystic insulinoma confirmed by histological examination after surgery, characterized by a high intracystic insulin concentration despite normal blood basal levels of the hormone.
  • [MeSH-major] Insulin / blood. Insulinoma / blood. Insulinoma / diagnosis. Pancreatic Neoplasms / blood. Pancreatic Neoplasms / diagnosis

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  • (PMID = 16293564.001).
  • [ISSN] 0036-5521
  • [Journal-full-title] Scandinavian journal of gastroenterology
  • [ISO-abbreviation] Scand. J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Norway
  • [Chemical-registry-number] 0 / Blood Glucose; 0 / Insulin
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95. Izumiyama H, Gotyo N, Fukai N, Ozawa N, Doi M, Yoshimoto T, Arii S, Hirata Y: Glucose-responsive and octreotide-sensitive insulinoma. Intern Med; 2006;45(8):519-24
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  • [Title] Glucose-responsive and octreotide-sensitive insulinoma.
  • Insulinoma is the most common cause of fasting hypoglycemia resulting from autonomous insulin hypersecretion.
  • Although fasting (10 hr) failed to provoke hypoglycemia, oral glucose tolerance test (GTT) caused an exaggerated insulin response (885 microU/ml) at 30 min, followed by hypoglycemia (36 mg/dl) after 90 min.
  • Moreover, intravenous GTT also induced an exaggerated insulin response (>2900 microU/ml) at 10 min, followed by hypoglycemia (34 mg/dl) after 40 min.
  • Although MRI and CT scan of the abdomen failed to detect any mass lesions in the pancreas, Octreoscan revealed increased radioactive uptake around the pancreatic head region.
  • At surgery, two islet cell adenomas were identified in the pancreas and resected.
  • Thus, this is a very rare case of glucose-responsive and octreotide-sensitive insulinoma in whom GTT and octreotide proved to be a useful provocation and treatment for hypoglycemic episodes.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Glucose Tolerance Test. Insulinoma / drug therapy. Octreotide / therapeutic use. Pancreatic Neoplasms / drug therapy
  • [MeSH-minor] Blood Glucose / analysis. Female. Humans. Hypoglycemia / etiology. Insulin / blood. Middle Aged

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  • (PMID = 16702744.001).
  • [ISSN] 1349-7235
  • [Journal-full-title] Internal medicine (Tokyo, Japan)
  • [ISO-abbreviation] Intern. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Blood Glucose; 0 / Insulin; RWM8CCW8GP / Octreotide
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96. Sa Cunha A, Beau C, Rault A, Catargi B, Collet D, Masson B: Laparoscopic versus open approach for solitary insulinoma. Surg Endosc; 2007 Jan;21(1):103-8
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  • [Title] Laparoscopic versus open approach for solitary insulinoma.
  • BACKGROUND: In recent years, advances in laparoscopic techniques have allowed surgeons to treat pancreatic lesions laparoscopically.
  • Insulinoma, the most prevalent pancreatic endocrine tumor, is mostly benign and curable with surgical resection.
  • This study aimed to assess the results from laparoscopic resection (LG) of insulinomas and to compare them with the results from open surgery (OG).
  • METHODS: From September 1999 to December 2005, 56 laparoscopic pancreatic resections were performed for selected patients, including 12 laparoscopic resections of insulinomas.
  • The results were compared with those of patients who underwent open resection of insulinomas selected from the authors' pancreatic database.
  • RESULTS: Three conversions to the open approach were required because of inability to identify the tumor.
  • The pancreatic fistula rate after laparoscopic enucleation was statistically lower than after open enucleation (14% vs 100%; p = 0.015).
  • CONCLUSION: This study demonstrates the feasibility and safety of laparoscopic resection of insulinomas.
  • The laparoscopic approach was associated with a decrease in hospital stay and pancreatic fistula after enucleation.
  • [MeSH-major] Insulinoma / surgery. Laparoscopy. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Endosonography. Feasibility Studies. Female. Follow-Up Studies. Humans. Incidence. Length of Stay. Magnetic Resonance Imaging. Male. Middle Aged. Pancreatic Fistula / epidemiology. Pancreatic Fistula / etiology. Radionuclide Imaging. Tomography, X-Ray Computed

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  • (PMID = 17008952.001).
  • [ISSN] 1432-2218
  • [Journal-full-title] Surgical endoscopy
  • [ISO-abbreviation] Surg Endosc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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97. Jonkers YM, Claessen SM, Perren A, Schmid S, Komminoth P, Verhofstad AA, Hofland LJ, de Krijger RR, Slootweg PJ, Ramaekers FC, Speel EJ: Chromosomal instability predicts metastatic disease in patients with insulinomas. Endocr Relat Cancer; 2005 Jun;12(2):435-47
NCI CPTC Antibody Characterization Program. NCI CPTC Antibody Characterization Program .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chromosomal instability predicts metastatic disease in patients with insulinomas.
  • Endocrine pancreatic tumors (EPTs) comprise a highly heterogeneous group of tumors with different clinical behavior and genetic makeup.
  • Insulinomas represent the predominant syndromic subtype of EPTs.
  • The metastatic potential of insulinomas can frequently not be predicted using histopathological criteria, and also molecular markers indicating malignant progression are unreliable because of the small number of cases per subtype studied so far.
  • For the identification of reliable indicators of metastatic disease, we investigated 62 sporadic insulinomas (44 benign and 18 tumors with metastases) by means of comparative genomic hybridization (CGH).
  • In addition, the role of MEN1 (multiple endocrine neoplasia type 1) gene mutations was determined to assess specific chromosomal alterations associated with dysfunction of this endocrine tumor-related tumor suppressor gene.
  • Only one case with a somatic MEN1 mutation was identified (1527del7bp), indicating that the MEN1 gene plays a minor pathogenic role in sporadic insulinomas.
  • CGH analysis revealed that the total number of aberrations per tumor differs strongly between the benign and the malignant group (4.2 vs 14.1; P<0.0001).
  • Furthermore, chromosome 9q gain was found to be the most frequent aberration in both benign and malignant insulinomas, whereas chromosome 6q losses and 12q, 14q and 17pq gains are strongly associated with metastatic disease.
  • Our study shows that chromosomal instability, as defined by > or =5 gains together with > or =5 losses, or total number of gains and losses > or =8, rather than parameters such as tumor size and proliferation index, is the most powerful indicator for the development of metastatic disease in patients with sporadic insulinoma.
  • [MeSH-major] Chromosomal Instability / genetics. Insulinoma / diagnosis. Pancreatic Neoplasms / diagnosis. Proto-Oncogene Proteins / genetics
  • [MeSH-minor] Adult. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Mutation. Neoplasm Metastasis. Nucleic Acid Hybridization. Prognosis

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  • (PMID = 15947114.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] England
  • [Chemical-registry-number] 0 / MEN1 protein, human; 0 / Proto-Oncogene Proteins
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98. Mei M, Deng D, Liu TH, Sang XT, Lu X, Xiang HD, Zhou J, Wu H, Yang Y, Chen J, Lu CM, Chen YJ: Clinical implications of microsatellite instability and MLH1 gene inactivation in sporadic insulinomas. J Clin Endocrinol Metab; 2009 Sep;94(9):3448-57
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  • [Title] Clinical implications of microsatellite instability and MLH1 gene inactivation in sporadic insulinomas.
  • CONTEXT: The molecular pathogenesis of sporadic insulinomas is unknown.
  • There is a lack of biomarker to distinguish benign and malignant form of insulinoma.
  • OBJECTIVE: Our objective was to confirm the occurrence of microsatellite instability (MSI) in insulinomas, to identify alterations of mismatch repair (MMR) genes in the tumors, and to evaluate the possibility to distinguish benign and malignant insulinoma or to predict the clinical outcome of patients with these alterations.
  • DESIGN AND PATIENTS: We detected MSI and inactivation of MLH1 gene in 55 sporadic insulinomas by PCR, immunohistochemical staining, allelic typing, analysis of promoter methylation, and exon mutations.
  • RESULTS: A high rate of MSI (MSI-H) was found in 33% of sporadic insulinomas.
  • Reduced expression of mutL homolog 1 (MLH1) protein was observed in 36% of insulinomas and correlated with MSI-H (P = 0.008).
  • Promoter methylation and loss of heterozygosity of MLH1 gene was found in 31 and 49% of insulinomas, respectively.
  • Reduced expression of MLH1 and MSI-H were significantly associated with both tumor malignancy (P = 0.033 and P = 4.8 x 10(-6), respectively) and incurable disease (P = 0.006 and P = 0.001, respectively).
  • CONCLUSION: High frequency of MSI occurred in sporadic insulinomas.
  • The silencing of MLH1 gene may partially contribute to the MSI-H in the tumors.
  • Assessing MSI-H and expressions of MLH1 could be used to distinguish benign and malignant insulinomas and to predict the outcome of patients.
  • [MeSH-major] Adaptor Proteins, Signal Transducing / genetics. Insulinoma / genetics. Microsatellite Instability. Nuclear Proteins / genetics. Pancreatic Neoplasms / genetics

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  • (PMID = 19567531.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adaptor Proteins, Signal Transducing; 0 / MLH1 protein, human; 0 / Nuclear Proteins; EC 3.6.1.3 / MSH2 protein, human; EC 3.6.1.3 / MutS Homolog 2 Protein
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99. Healy ML, Dawson SJ, Murray RM, Zalcberg J, Jefford M: Severe hypoglycaemia after long-acting octreotide in a patient with an unrecognized malignant insulinoma. Intern Med J; 2007 Jun;37(6):406-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Severe hypoglycaemia after long-acting octreotide in a patient with an unrecognized malignant insulinoma.
  • Insulinomas are the most common hormone-producing pancreatic neuroendocrine tumours (NETs), and patients usually present with symptoms secondary to hypoglycaemia.
  • Octreotide has been widely used in the symptomatic treatment of patients with pancreatic NETs, including insulinomas.
  • We describe a case of a patient with a metastatic NET, subsequently identified as a malignant insulinoma, who developed severe hypoglycaemia after treatment with long-acting octreotide.
  • [MeSH-major] Hypoglycemia / chemically induced. Insulinoma / drug therapy. Octreotide / adverse effects. Pancreatic Neoplasms / drug therapy

  • Genetic Alliance. consumer health - Insulinoma.
  • MedlinePlus Health Information. consumer health - Hypoglycemia.
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  • (PMID = 17535385.001).
  • [ISSN] 1445-5994
  • [Journal-full-title] Internal medicine journal
  • [ISO-abbreviation] Intern Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Delayed-Action Preparations; RWM8CCW8GP / Octreotide
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100. Sheikh A, Zuberi L, Haque N: Rare among the rarities--recurrent insulinoma. J Coll Physicians Surg Pak; 2007 Jun;17(6):364-6
MedlinePlus Health Information. consumer health - Pancreatic Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Rare among the rarities--recurrent insulinoma.
  • A patient with recurrent insulinoma without co-existing multiple endocrine neoplasia syndrome is described.
  • In a 32-year-old man with recurrent episodes of symptomatic hypoglycemia, the supervised fast showed high insulin (24.5 IU/ml) and C-peptide level (3.06 ng/ml) with low blood sugar (27 mg/dl).
  • A 1 x 1.5 cm nodule from the lower part of pancreatic body was removed on exploratory laparotomy.
  • Histopathology confirmed the diagnosis of islet cell tumor.
  • After 11 years, he started experiencing symptomatic hypoglycemic episodes with inappropriately elevated serum insulin and C-peptide levels (2.2 ng/ml).
  • On pancreatic angiography, a 16 x 11 mm size tumor blush was noted.
  • Histopathology confirmed the diagnosis of insulinoma.
  • He was given small amounts of intermediate acting insulin in early postoperative period, which was discontinued shortly thereafter.
  • [MeSH-major] Insulinoma / diagnosis. Neoplasm Recurrence, Local. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Adult. Angiography. Blood Glucose / metabolism. C-Reactive Protein / metabolism. Diagnosis, Differential. Follow-Up Studies. Humans. Insulin / blood. Male. Pancreatectomy. Splenectomy

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  • (PMID = 17623590.001).
  • [ISSN] 1022-386X
  • [Journal-full-title] Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
  • [ISO-abbreviation] J Coll Physicians Surg Pak
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Pakistan
  • [Chemical-registry-number] 0 / Blood Glucose; 0 / Insulin; 9007-41-4 / C-Reactive Protein
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