ECE2015 Eposter Presentations Endocrine tumours (69 abstracts)
Insulinoma: a multicentre and retrospective analysis of the Spanish experience during three decades
Pedro Iglesias 1 , Christian Lafuente 1 , María Angeles Martín Almendra 2 , Antonio López-Guzmán 3 , José Carlos Castro 4 & Juan José Díez 1
1Department of Endocrinology, Hospital Ramón y Cajal, Madrid, Spain; 2Department of Endocrinology, Hospital Virgen de la Concha, Zamora, Spain; 3Department of Endocrinology, Hospital Nuestra Señora de Sonsoles, Avila, Spain; 4Department of Endocrinology, Hospital General, Segovia, Spain.
Objective: To characterise insulinoma diagnosed and treated in the period 1983–2014 in various hospitals in Spain.
Methods: Inclusion criteria were the presence of biochemical and morphological criteria compatible with insulinoma and/or histologic demonstration of tumour.
Results: Twenty-nine patients (23 women (79.3%); mean age 48.7±17.4 years (range, 16–74)) were recruited. In 26 (89.7%) cases the tumor was sporadic and the rest (3 women, 10.3%) was presented in the context of multiple endocrine neoplasia (MEN 1). There were 3 (10.3%) multiple insulinomas, one associated with MEN and 2 (6.9%) sporadic malignant insulinomas. The majority (n=18, 62.1%) showed fasting hypoglycaemia, about a third (31%) both postprandial and fasting hypoglycaemia and 6.9% postprandial hypoglycaemia only. Time to reach nadir of glucose (37.3±6.5 mg/dl) in the fasting test was 9.0±4.4 h, with maximal insulinaemia of 25.0±20.3 mcU/ml. Abdominal CT detected insulinoma in 75% of patients. Twenty seven (93.1%) patients underwent surgery (enucleation, 18 (66.7%) and subtotal pancreatectomy was performed in 9 (33.3%) patients; mean tumour size was, 1.7±0.7 cm). Surgery achieved cure in the majority (n=24, 88.9%) of patients.
Conclusion: Insulinoma is usually a benign, small and solitary tumour, affecting predominantly women aged 45–50 years which is habitually located with abdominal CT. Open surgery by enucleation is the most commonly used surgical technique achieving a high cure rate.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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