Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Surgical Management, Preoperative Tumor Localization, and Histopathology of 80 Patients Operated on for Insulinoma

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Longitudinal Increases in Serum Insulin-like Factor 3 and Testosterone Determined by LC-MS/MS in Pubertal Danish Boys

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Marked Increase in Incident Gynecomastia: A 20-Year National Registry Study, 1998 to 2017

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Oral D/L-3-Hydroxybutyrate stimulates cholecystokinin and insulin secretion and slows gastric emptying in healthy males

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Apolipoprotein M and risk of type 2 diabetes

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Disease Control and Gender Predict the Socioeconomic Effects of Acromegaly: A Nationwide Cohort Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Co-existence of starvation ketoacidosis and hyperthyroidism in early pregnancy: a case report

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

INTRODUCTION: Diagnosis and pathological classification of insulinomas are challenging.

AIM: To characterize localization of tumors, surgery outcomes, and histopathology in patients with insulinoma.

METHODS: Patients with surgically resected sporadic insulinoma were included.

RESULTS: Eighty patients were included. Seven had a malignant tumor. A total of 312 diagnostic examinations were performed: endoscopic ultrasonography (EUS; n = 59; sensitivity, 70%), MRI (n = 33; sensitivity, 58%), CT (n = 55; sensitivity, 47%), transabdominal ultrasonography (US; n = 45; sensitivity, 40%), somatostatin receptor imaging (n = 17; sensitivity, 29%), 18F-fluorodeoxyglucose positron emission tomography/CT (n = 1; negative), percutaneous transhepatic venous sampling (n = 10; sensitivity, 90%), arterial stimulation venous sampling (n = 20; sensitivity, 65%), and intraoperative US (n = 72; sensitivity, 89%). Fourteen tumors could not be visualized. Invasive methods were used in 7 of these 14 patients and localized the tumor in all cases. Median tumor size was 15 mm (range, 7 to 80 mm). Tumors with malignant vs benign behavior showed less staining for insulin (3 of 7 vs 66 of 73; P = 0.015) and for proinsulin (3 of 6 vs 58 of 59; P < 0.001). Staining for glucagon was seen in 2 of 6 malignant tumors and in no benign tumors (P < 0.001). Forty-three insulinomas stained negative for somatostatin receptor subtype 2a.

CONCLUSION: Localization of insulinomas requires many different diagnostic procedures. Most tumors can be localized by conventional imaging, including EUS. For nonvisible tumors, invasive methods may be a useful diagnostic tool. Malignant tumors showed reduced staining for insulin and proinsulin and increased staining for glucagon.

Original languageEnglish
JournalThe Journal of clinical endocrinology and metabolism
Volume104
Issue number12
Pages (from-to)6129-6138
Number of pages10
ISSN0021-972X
DOIs
Publication statusPublished - 1 Dec 2019

ID: 58981560