Single Institutional Experiences of Insulinoma

Lee, Sun Hyuck; Kang, Chang Moo; Kim, Jun Young; Choi, Gi Hong; Kim, Kyung Sik; Choi, Jin Sub; Lee, Woo Jung; Kim, Byong Ro

Abstract

PURPOSE: We present our experiences of pancreatic insulinoma among the functioning neuroendocrine neoplasm of the pancreas, to review the natural history and suggest proper management.
METHODS
From June 1990 to August 2006, patients with diagnosis of pancreatic insulinoma were retrospectively reviewed.
RESULTS
Thirteen patients (5 men and 8 women) with median age of 42 years (range, 12~68 years) were investigated. One patient (12%) with pancreatic insulinoma was MEN 1. Intraoperative ultrasound scan (sensitivity, 88%) was the most powerful modality for tumor localization. Sixteen neoplasms with median tumor size 1 cm (range, 0~3 cm) were found. Ten neoplasm (62%) were located in the heads/ necks of the pancreas. Six neoplasm (38%) were located in the tails. Five neoplasm (31%) were located around the neck areas near the SMV or PV. Twelve patients (92%) underwent enucleation, and two patients (15%) underwent distal pancreatectomy with splenectomy. 100% of patients with pancreatic insulinoma have survived and the overall disease free 10-year survival was found to be about 85.7%.
CONCLUSION
Exact localization of tumor by intraoperative ultrasound and effective surgical removal can be significantly beneficial for good prognosis.