Insulinoma

Abstract

Insulinomas are fascinating tumors in terms of their great diversity in symptoms, the difficulties in establishing the diagnosis, and the operative challenge. Although many patients present with obvious symptoms and a clear biochemical diagnosis and the operation is straightforward, other cases may offer the surgeon great difficulties. The main problems are the sometimes nonspecific symptoms not recognized as hypoglycemia, with potential devastating consequences, including permanent hypoglycemic brain damage, the sometimes difficult localization procedures as well as need for correct intraoperative decisions, and the potential of malignancy or multiple tumors as in multiple endocrine neoplasia type 1 (MEN-1). Insulinoma is the most common of several causes for organic hyperinsulinism. A review of this small, often benign, but still dangerous tumor is presented in this chapter.