Carcinoma of the Islands of the Pancreas

Wilder, Russell M.; Allan, Frank N.; Power, Marschelle H.; Robertson, H. E.

doi:10.1001/jama.1927.02690050014007

Cited by 410 publications

(53 citation statements)

References 18 publications

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“…The association between insulinoma and hypoglycemia was first recognized in 1927, when extracts from a metastatic insulinoma were injected into a rabbit to produce effects of hypoglycemia. 9 Two years later, Roscoe Graham performed the first curative operation for a benign insulinoma in Toronto, Canada. 10 Since that time there have been many reports of successful management of insulinoma in both the medical and surgical literature.…”

Section: Discussionmentioning

confidence: 99%

Improved Contemporary Surgical Management of Insulinomas

Nikfarjam¹,

Warshaw²,

Axelrod³

et al. 2008

Annals of Surgery

191

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Section: Discussionmentioning

confidence: 99%

Improved Contemporary Surgical Management of Insulinomas

Nikfarjam¹,

Warshaw²,

Axelrod³

et al. 2008

Annals of Surgery

191

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“…1) is the most common functioning neuroendocrine tumor of the pancreas, first described in 1927 (19). According to a population-based study, it occurs with an incidence of 4 per million patient years (20).…”

Section: Insulinomamentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Pathogenesis and management of hypoglycemia

Kittah

Vella

2017

European Journal of Endocrinology

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Glucose is the main substrate utilized by the brain and as such multiple regulatory mechanisms exist to maintain glucose concentrations. When these mechanisms fail or are defective, hypoglycemia ensues. Due to these robust mechanisms, hypoglycemia is uncommon and usually occurs in the setting of the treatment of diabetes using glucose-lowering agents such as sulfonylureas or insulin. The symptoms of hypoglycemia are non-specific and as such it is important to confirm hypoglycemia by establishing the presence of Whipple's triad before embarking on an evaluation for hypoglycemia. When possible, evaluation of hypoglycemia should be carried out at the time of spontaneous occurrence of symptoms. If this is not possible then one would want to create the circumstances under which symptoms occur. In cases where symptoms occur in the post absorptive state, a 72-h fast should be performed. Likewise, if symptoms occur after a meal then a mixed meal study may be the test of choice. The causes of endogenous hyperinsulinemic hypoglycemia include insulinoma, post-bariatric hypoglycemia and noninsulinoma pancreatogenous hypoglycemia syndrome. Autoimmune hypoglycemia syndrome is clinically and biochemically similar to insulinoma but associated with high levels of insulin antibodies and plasma insulin. Other important causes of hypoglycemia include medications, non-islet cell tumors, hormonal deficiencies, critical illness and factitious hypoglycemia. We provide an overview of the pathogenesis and management of hypoglycemia in these situations.

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“…pNETs can present without hormonal symptoms (nonfunctioning tumors) [4,5] or cause hormonal symptoms (functioning tumors). The functioning tumors are divided into insulinomas [6], gastrinomas [7], glucagonomas [8], and VIPomas [9]. The only curative therapy is surgical resection of the pNET [10], but metastases are often present at diagnosis [2].…”

Section: Introductionmentioning

confidence: 99%

Streptozocin and 5-Fluorouracil for the Treatment of Pancreatic Neuroendocrine Tumors: Efficacy, Prognostic Factors and Toxicity

et al. 2015

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Background: In our center,the combination of streptozocin (STZ) and 5-fluorouracil (5-FU) has been used as the first-line treatment in the majority of patients with pancreatic neuroendocrine tumors (pNETs) over the past few decades. The objective of the current study was to assess the efficacy, prognostic factors and safety of the combination of STZ and 5-FU. Patients and Methods: Medical records and radiological reports of 133 patients with pNETs who received the combination of STZ and 5-FU during the period 1981-2014 were retrospectively evaluated. Results: The median survival from the start of treatment was 51.9 months in the whole group. In the radiologically evaluable patients (n = 100), progression-free survival was 23 months. Complete response was reached in 3 patients (3%), partial response in 25 patients (25%), 64 patients (64%) had stable disease, and 8 patients (8%) had progressive disease. In a multivariate analysis, surgery of the primary tumor and having a G3 tumor were significant positive and negative prognostic factors of survival from the start of treatment, respectively. Having either a G3 tumor or a stage IV tumor were significant prognostic factors for a shorter progression-free survival. Chemotherapy had to be discontinued in 29 patients due to side effects, of which kidney toxicity (mainly grades 1-2) was the most frequent. Conclusion: As shown in recent reports, the combination of STZ and 5-FU is effective in the treatment of pNETs in terms of survival and radiological response and has an acceptable toxicity profile.

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Carcinoma of the Islands of the Pancreas

Cited by 410 publications

References 18 publications

Improved Contemporary Surgical Management of Insulinomas

Improved Contemporary Surgical Management of Insulinomas

MANAGEMENT OF ENDOCRINE DISEASE: Pathogenesis and management of hypoglycemia

Streptozocin and 5-Fluorouracil for the Treatment of Pancreatic Neuroendocrine Tumors: Efficacy, Prognostic Factors and Toxicity

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