CLINICAL ONCOLOGY AND RESEARCH | ISSN 2613-4942
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*
Correspondence to: Aun Jamal, M.B.B.S., M.R.C.P.S., M.R.C.S.Ed., F.C.P.S., Fellow in Surgical Oncology, Shaukat Khanum memorial Cancer Hospital &
Research Center, Pakistan; Tel: 00923006662557; E-mail: dr_abdalian@live.com
Research Article
Insulinoma of Pancreas, Brief Experience at a Dedicated Surgical Oncology
Department
Aun Jamal
1*
, Jibran Mohsin
1
, Ihtisham ul Haq
1
, Noor-ul- Mobeen
1
, Saleema Begum
5
, Osama Shakeel
2
, Syed Irfan
Kabir
4
, Amir Ali Syed
3
and Shahid Khattak
4
1
Fellow in Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Pakistan
2
Resident General Surgery, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Pakistan
3
Consultant Oncological Surgeon, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Pakistan
4
Consultant Surgeon, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Pakistan
5
Senior Instructor in Hepatobiliary Surgery, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Pakistan
A R T I C L E I N F O
Article history:
Received: 13 July, 2020
Accepted: 24 July, 2020
Published: 10 August, 2020
Keywords:
Hypoglycemia
insulinoma
C-Peptide
72-hour fasting test
minimally invasive surgery
A B S T R A C T
Introduction: Insulinoma of pancreas is a rare neuroendocrine tumor (NET). Mostly insulinomas are
benign and solitary. They can have association with multiple endocrine neoplasia 1 (MEN -1). Insulinomas
presents with symptoms of hypoglycemia. Most of the times the symptoms are vague and result in delay in
the diagnosis and hence management. After appropriate diagnostic and localization investigations along
with metastatic workup, surgery is the treatment of choice. Surgery can offer cure. Minimally invasive
surgery can offer potential benefits of minimal morbidity and at least equal oncological outcomes.
Study Design: Case series.
Place and Duration of Study: Department of Surgical Oncology, Shaukat Khanam Memorial Cancer
Hospital & Research Center (SKMCH&RC), from January 2011 to March 2020.
Methodology: We studied a total of five patients that presented to SKMCH&RC in the above-mentioned
period. Detailed clinical information of these five patients, including sociodemographic variables,
symptomatology, diagnostic and localization investigations, clinical and pathological staging,
comprehensive details of surgery, postoperative course, oncological outcomes, postoperative resolution of
symptoms, postoperative diabetes, prognosis and follow up duration were analysed. The record was being
retrospectively retrieved from Hospital Information System (HIS) that is prospectively maintained. We are
a paperless hospital and all data and record of the patient is maintained through HIS.
Results: A total of five patients presented to SKMCH&RC with a mean age of 41 (18 -80) years. The
median duration of symptoms was 24 (6-60) months. Symptomatic hypoglycemia was present in all 5
(100%) of the patients. Tumor distribution in the pancreas was as follows; uncinate 1 (20%), body 1 (20%)
and tail 3 (60%). All five patients (100%) were treated by surgery. Resolution of symptoms occurred in all
five (100%) of the patients.
Conclusion: Insulinoma of pancreas is a rare disease with varied symptomatology, physicians shall have
an index of suspicion for this disorder to aid early diagnosis that is pivotal for the management and
prevention of possible fatal complications of hypoglycemia. Appropriate diagnostic and localizing
investigations are required. Adequate surgery can offer cure. Minimally invasive surgery can be safely
offered with equal oncological outcomes.
© 2020 Aun Jamal. Hosting by Science Repository.
© 2020 Aun Jamal. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
http://dx.doi.org/10.31487/j.COR.2020.08.10