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Francesco Lapolla, Alessandra di Lascia and Vincenzo Neri
Scientific Tracks Abstracts: Endocrinol Metab Synd
Background: Insulinoma is a rare neuroendocrine tumor with an incidence of 4 per 1 million persons per year and represents 1-2% of all pancreatic neoplasms. In the past, the diagnosis was confirmed by the presence of the Whipple triad and usually meant that a patient was led directly to surgery. Aim: We reviewed the literature reporting the last news in instrumental options and therapeutic choices referred to our recent experience of 4 cases of insulinoma diagnosed and treated in our Institution Patients & methods: We report 4 recent diagnosed and treated cases of insulinoma in our Institution. However delays in the diagnosis of insulinoma are common because the symptoms usually precede detection of a tumor and there may be misattribution of the symptoms to psychiatric, cardiac, or neurological disorders. After the clinical diagnosis the need for preoperative localization of insulinomas and the methods used remain contentious. Results: In our recent experience we achieved a preoperative localization with imaging procedures (currently with CT and MRI), in one case also with angiography. Regarding the therapy, because most insulinomas are solitary, benign and intrapancreatic, tumor enucleation is the procedure of choice, when possible. Insulinomas tend to be compact and encapsulated, presenting a clear dissection plane between the tumor and the surrounding pancreas. Conclusion: The use of current imaging procedures (CT, MRI and sometimes angiography) remains needful to identify the location of the insulinoma and enables the surgeon to proceed with surgery ensuring, in most cases, a successful outcome.
Francesco Lapolla is born in Foggia, Italy, on 7th June 1984. He graduated on 2008 in Medicine and Surgery at the University of Foggia. He is resident in School of General Surgery, University of Foggia. He is member of the following scientific associations: AISP, EPC, IAP. He is author of 6 scientific papers,17 abstracts and he is member of the Italian editorial boad of the Merck manual of Diagnosis and Therapy.