Insulinoma

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Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Breed predisposition, Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Subsequent management, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications,
Contributors
Synonyms Hyperinsulinism, insulin-secreting tumor, islet cell tumor

Introduction

  • Very rare neoplasm of pancreatic islets beta cells (only handful of cases reported).
  • Cause : functional insulin secreting neoplasm of pancreatic islet cells.
  • Signs : (hypoglycemia) episodic seizures, weakness, collapse.
  • Diagnosis : glucose and insulin levels.
  • Treatment : dietary control, prednisolone, and surgery.
  • Prognosis : guarded as tumors often malignant.

Diagnosis

Clinical signs

  • No visible or palpable abnormalities.
  • Muscle fasciculations.

Diagnosis

Differential diagnosis

Metabolic disorders
  • Other causes of hypoglycemia:
    • Hepatic disease.
    • Neoplasia.
    • Sepsis.
    • Starvation (young kittens).
  • Hepatic encephalopathy  Hepatic encephalopathy  .
  • Hypocalcemia .
  • Anemia  Anemia: overview  .
  • Hypokalemia.
  • Uremia, eg renal failure  Kidney: chronic kidney disease  .

Sequelae

Prognosis

Surgical management
  • Some cases have survived several years with treatment.

Medical management

  • Probably shorter remission periods than following surgery.

Expected response to treatment

  • Rapid resolution of clinical signs.

Reasons for treatment failure

  • Side-effects of therapy.
  • Metastasis.

Sources

Publications

Refereed papers

  • O'Brien T D, Norton F, Turner T M, Johnson K H. (1990)Pancreatic endocrine tumour in a cat:clinical, pathological and immunohistochemical evaluation.JAAHA26, 453-457.
  • McMillan F D, Barr B, Feldman C (1985)Functional islet cell tumour in a cat.JAAHA21, 741-746.

Other sources of information

  • Canine and Feline Endocrinology and Reproduction, EC Feldman and RW Nelson (1996). WB Saunders, Philadelphia pp422.

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