Abstract:
Introduction: Insulinomas are rare neoplasias with incidence of 1-4
cases per million population annually, but still most common from
pancreatic neuroendocrine tumours.Purpose: An analysis of the sensitivity and specificity of
insulinoma diagnostic methods. Material and methods: Here are discussed diagnostic data of 15
patients with insulinoma between 1993 and 2021 from clinic no. 1
of the surgery department no. 2. Diagnosis rely on clinical
presentation, laboratory findings (glycemic profile, glucose levels
during hypoglycemic accesses, convulsive attacks, after 40%
glucose solution administration, as well as levels of seric insulin
and C-peptide) and imagistic methods as ultrasonography
(Figure. 2), CT (Figure.3), MRI (Figure .4). Results: Clinical presentation are dominated by neuropsychic
symptoms 13 (86,6%) cases, followed by adrenergic symptoms 10
(66,7%) cases, digestive symptoms 8 (53,3%) cases, and
cushingoid manifestations 3 (20%) cases (Figure 1). Glucose levels
during hypoglycemic attacks were between 2,0-3,0 mmol/l, after
40% glucose solution infusion - 3,8-5,8 mmol/l. Median level of Cpeptide was 4,6 ng/l , of insulin was 32,45 µmol/l. Imagistic was
found tumours between 0,8 and 2,5 cm in size, 10 (66,4%) cases in
corporeal site (Figure.2 , Figure.4) and 5 (33,6%) cases in caudal
site (Figure.3). Conclusions: The diagnostic of an insulinoma is still a dilemma, relying
mostly on clinical manifestations and laboratory findings while there are
no unanimously accepted imagistical criteria.
Description:
Department of Surgery no. 2, scientific research laboratory "Reconstructive surgery of the digestive tract„ SUMPh ”Nicolae Testemițanu” ,
PMSI CRH ”Timofei Moșneaga”
