Insulinomatosis: a very rare cause of pancreatic neuroendocrine tumor
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Keywords

hypoglycemia
insulinoma
nesidioblastosis
insulinomatosis
pancreatic neuroendocrine

How to Cite

Jaramillo Chacón, H., González Devia, D., López Panqueva, R. P., Cañon Solano, D., Aguirre Matallana, D., Rey Rubiano, A. M., Segovia Gómez, J. M., & Dussan Flórez, R. F. (2020). Insulinomatosis: a very rare cause of pancreatic neuroendocrine tumor. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 7(2), 76–85. https://doi.org/10.53853/encr.7.2.607

Abstract

Pancreatic neuroendocrine tumors represent 2-10 % of all tumors of the pancreas and approximately 7 % of all neuroendocrine tumors. They are classified as functioning or non-functioning depending on the presence or absence of clinical syndromes associated with hormonal hypersecretion. Insulinomas are the most frequent functioning pancreatic neuroendocrine tumors (45 % of cases), and the most frequent cause of persistent hyperinsulinemic hypoglycemia in adults. Furthermore, 10 % of pancreatic neuroendocrine tumors are associated with multiple endocrine neoplasia type 1 (MEN-1). Insulinomatosis is a distinct clinical entity in which there are multiple insulinomas.
Objectives: Present the cases reported to the date of insulinomatosis and describe the genetic causes, clinical characteristics, treatment and prognosis of insulinomatosis.
Methods: A search about insulinomatosis and the factors that govern beta cells proliferation was conducted in the databases of PubMed, Medline and Google Scholar until July 2020.
Results: 108 cases of patients with insulinomatosis have been reported to date, is recurrent and rarely malignant; multiple protooncogenes and tumor suppressors control locally and systemically the growth of beta cells; however, few have been studied in the tumoral landscape, and MafA mutation in p.Ser64Phe has been involved.
Conclusion: Insulinomatosis is characterized by the synchronous and metachronous occurrence of insulinomas; it has a histological, clinical and genetic phenotype different from other pancreatic neuroendocrine tumors. MEN-1 genetic testing is negative, can be sporadic or hereditary, and MafA could be a driver mutation.

https://doi.org/10.53853/encr.7.2.607
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