General Information About Pancreatic Neuroendocrine Tumors (islet Cell Tumors)
Pancreatic neuroendocrine tumors form in hormone-making cells (islet cells) of the pancreas. The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas lies behind the stomach and in front of the spine. Enlarge There are two kinds of cells in the pancreas: Endocrine pancreas cells make several kinds of hormones (chemicals that control the actions of certain cells or organs in the body), such as insulin to control blood sugar. They cluster together in many small groups (islets) throughout the pancreas. Endocrine pancreas cells are also called islet cells or islets of Langerhans. Tumors that form in islet cells are called islet cell tumors, pancreatic endocrine tumors, or pancreatic neuroendocrine tumors (pancreatic NETs). Exocrine pancreas cells make enzymes that are released into the small intestine to help the body digest food. Most of the pancreas is made of ducts with small sacs at the end of the ducts, which are lined with exocrine cells. This summary discusses islet cell tumors of the endocrine pancreas. See the PDQ summary on Pancreatic Cancer Treatment for information on exocrine pancreatic cancer. Pancreatic neuroendocrine tumors (NETs) may be benign (not cancer) or malignant (cancer). When pancreatic NETs are malignant, they are called pancreatic endocrine cancer or islet cell carcinoma. Pancreatic NETs are much less common than pancreatic exocrine tumors and have a better prognosis. Pancreatic NETs may or may not cause signs or symptoms. Most pancreatic NETs are functional tumors. There are different kinds of functional pancreatic NETs. Pancreatic NETs make different kinds of hormones s Continue reading >>
What Are The Symptoms Of Insulinoma In Ferrets?
The most common symptoms of insulinoma (tumors on the pancreas which stimulates insulin to be released, causing low blood sugar) are: Staggering or falling over like drunk Drooling Head bobbing Screaming seizure Head pulled back or severely to the side Pawing at the mouth (a symptom of nausea) Give something sweet (Karo syrup, honey, jelly, Ferretvite, Nutrical — anything with sugar in it) by rubbing it on the gums (or if they are conscious, feeding it to them). Keep rubbing it on the gums until they wake up. If they are awake, feed as much as they will take. After giving the sweet stuff, feed a high protein meal like chicken or turkey baby food (the kind that is just meat & gravy, no vegetables or noodles). Warm the baby food and add some water to make it a broth. They should eat at least 1/3 a jar. The fluids seem to help get the sugar into the blood stream. If they were screaming or unconscious, take to emergency vet. If they were not screaming or unconscious and they perk up and act normal again, make an appointment within the next day or two. This will happen again and eventually can cause brain damage, especially if the blood sugar gets low enough to cause a seizure. Once stabilized, the usual treatment is prednisolone liquid. Most vets start with .25mg twice a day, roughly 12 hours apart. Twice is better than once since pred leaves the system within 12 hours. Early signs of insulinoma can be: Gradually getting thin Lack of energy, not playing Doing “flat ferret” frequently (flat ferret is when they suddenly lie down flat on the floor) Twitching of the head or eyes Staggering once or twice, especially before eating Drooling, even if they are otherwise acting okay Perking up after given something sweet These early signs can also be signs of other problems, so Continue reading >>
What are the other Names for this Condition? (Also known as/Synonyms) Beta Cell Tumor of Pancreas Islet Cell Insulinoma Pancreatic Insulinoma What is Insulinoma? (Definition/Background Information) Insulinoma is a rare tumor of the beta cells of the pancreas, which secretes insulin. They are considered to be functionally-active tumors, because they secrete insulin. Due to this secretion, they cause low blood glucose levels, which is termed ‘clinical hypoglycemia’ About 90% of Insulinomas have a benign behavior, while 10% may turn malignant. These pancreatic tumors generally occur in adults, especially in women These tumors may be small and during the early stages may not cause any significant signs and symptoms, making it difficult to detect an Insulinoma. Malignant tumors have more severe signs and symptoms than benign tumors Insulinoma can cause sweating, vision abnormalities, confusion, etc. in the affected individuals, due to reduced glucose levels in blood. Malignant tumors may infiltrate into local tissue or even metastasize There are various treatment modalities available to address the condition; although, a complete surgical excision is the preferred mode of treatment. In cases of metastasis, a combination of chemotherapy, radiation therapy, and surgical procedures may be used The prognosis of Insulinoma depends upon many factors including the behavior of the tumor (if benign or malignant) and overall health of the individual. Generally, a benign Insulinoma has an excellent prognosis with appropriate treatment The pancreas is an important organ of the digestive system. Based on function of the pancreas, it can be functionally divided into 2 parts, namely: Exocrine pancreas, which produces digestive enzymes, and Endocrine pancreas that produces hormones such Continue reading >>
insulinoma [in″su-lin-o´mah] a tumor of the beta cells of the islets of Langerhans; although usually benign, it is one of the chief causes of hypoglycemia. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. in·su·li·no·ma (in'sŭ-li-nō'mă), An islet cell adenoma that secretes insulin. insulinoma /in·su·li·no·ma/ (in″sdbobr-lin-o´mah) an islet cell tumor of the beta cells, usually benign, that secretes insulin and is one of the chief causes of hypoglycemia. insulinoma insulinoma A well-differentiated pancreatic endocrine neoplasm associated with Whipple's triad: (1) Symptoms and signs of hypoglycaemia; (2) Concomitant plasma glucose level of 45 mg/dL or less; and (3) Symptoms reverse with the administration of glucose. Amyloid is often found in insulinomas. Prognosis Insulinomas, especially if small, have an excellent prognosis. insulinoma Insuloma Oncology A pancreatic islet cell tumor, which is characterized by overproduction of insulin, resulting in hypoglycemia of sufficient severity to trigger a coma; insulinomas are typical of MEN I. See MEN I. insulinoma A rare tumour of the INSULIN -producing cells of the PANCREAS. Insulinomas can produce large quantities of insulin and lead to the dangerous condition of HYPOGLYCAEMIA. insulinoma a tumor of the beta cells of the islets of Langerhans; although usually benign, it is one of the chief causes of hypoglycemia. Continue reading >>
An insulinoma is a rare pancreatic beta-cell tumor that hypersecretes insulin. The main symptom is fasting hypoglycemia. Diagnosis is by a 48- or 72-h fast with measurement of glucose and insulin levels, followed by endoscopic ultrasound. Treatment is surgery when possible. Drugs that block insulin secretion (eg, diazoxide, octreotide, calcium channel blockers, beta-blockers, phenytoin) are used for patients not responding to surgery. Insulinomas are a type of pancreatic endocrine tumor that arises from islet cells. Of all insulinomas, 80% are single and may be curatively resected if identified. Only 10% of insulinomas are malignant. Insulinoma occurs in 1/250,000 at a median age of 50 yr, except in multiple endocrine neoplasia (MEN) type 1 (about 10% of insulinomas), when it occurs in the 20s. Insulinomas associated with MEN 1 are more likely to be multiple. Surreptitious administration of exogenous insulin can cause episodic hypoglycemia mimicking insulinoma. Hypoglycemia secondary to an insulinoma occurs during fasting. Symptoms of hypoglycemia due to insulinoma are insidious and may mimic various psychiatric and neurologic disorders. CNS disturbances include headache, confusion, visual disturbances, motor weakness, palsy, ataxia, marked personality changes, and possible progression to loss of consciousness, seizures, and coma. Symptoms of sympathetic stimulation (faintness, weakness, tremulousness, palpitation, sweating, hunger, and nervousness) are often present. Plasma glucose should be measured during symptoms. If hypoglycemia is present (glucose < 40 mg/dL [2.78 mmol/L]), an insulin level should be measured on a simultaneous sample. Hyperinsulinemia of > 6 μU/mL (42 pmol/L) suggests an insulin-mediated cause, as does a serum insulin to plasma glucose ratio > 0. Continue reading >>
What Is Insulinoma In Ferrets?
What is insulinoma? Insulinoma is a tumor affecting a ferret's pancreas, which causes a cancer of the pancreas and destabilises the level of insulin in the ferret. This causes spikes in the quantity of insulin produced meaning that your ferret can become permanently hypoglycaemic (low blood sugar). Insulinoma usually affects older ferrets between the ages of 3 and 7 with no distinction as to sex. What are the symptoms? Fatigue Lethargy Weight loss Excessive salivation Vomiting Incoordination of paws Fits: During fits, your ferret may fall on their side and convulse. How is it diagnosed? The diagnosis of insulinoma can only be confirmed after multiple tests measuring the level of glucose in the blood. This level can vary over time. Hospitalisation for a whole day will therefore be necessary. If the ferret presents with a lower level than 0.7 grams per litre, they will need to undergo an echography of the abdomen or an exploratory laparotomy to confirm the presence of the nodules. What is the treatment? Treatment against insulinoma can be either surgical or medial: Surgical treatment: If the ferret is under the age of 6, a surgical operation is usually preferred. In consists of removing the pancreatic tumors that are visible to the naked eye. However, this operation doesn't guarantee complete recovery. It will however slow down considerably the progression of the disease. Medical treatment: This method consists of administrating medicine with a view to increasing the blood sugar levels. It doesn't cure the cancer but will slow its progression and treat the symptoms. If you have any doubts, it is best to take your ferret to the veterinary immediately because insulinoma spreads very quickly. You should therefore react quickly in order to minimise the damage to your ferret! Continue reading >>
Insulinoma In Dogs
Overview The pancreas has many important functions including aiding in the digestion of the food your dog eats and secreting insulin, which helps regulate your dog’s glucose (“sugar”) levels. An insulinoma is a tumor of the pancreas that affects the regulation of your dog’s sugar levels, causing hypoglycemia, also referred to as low blood sugar. This tumor usually occurs in middle-aged or older dogs. Both mixed breeds and pure breeds can be affected by this type of tumor. Some of the most common pure breeds at risk are: Symptoms While you won’t be able to see the tumor causing insulinoma, you will notice the side effects of hypoglycemia (low-blood sugar). These can include: Diagnosis Your veterinarian will give your dog a complete physical exam and take a thorough history of her symptoms. They will most likely want to run diagnostic tests, which could include: Urine tests to rule out urinary tract infections and evaluate the kidney’s ability to concentrate urine Chemistry tests to evaluate kidney, liver, and pancreatic function, as well as sugar levels A complete blood count to evaluate if there are enough red blood cells present in your dog’s blood Electrolyte tests to evaluate hydration status and choose proper fluid supplements, if your pet is dehydrated Radiographs (x-rays) and/or an ultrasound to visually evaluate the structure of the pancreas and kidneys A thyroid test to determine if the thyroid gland is producing too little thyroid hormone Insulin blood levels X-rays of the chest and abdomen to check for underlying primary or secondary tumors (metastasis) An abdominal ultrasound to check for tumors of the pancreas and/or evidence of metastasis Treatment Treatment recommendations may include surgery or medications to manage the hypoglycemia. Additio Continue reading >>
What is an insulinoma? Insulinoma is a tumor of the pancreas that produces excessive amounts of insulin. Insulinomas are more common in women. The tumors are usually small (less than 2cm) and more than 90% of all insulinomas are benign (non-cancerous). Insulinomas produce excessive amounts of insulin and this causes low blood sugar. The typical symptoms that patients complain about are related to the development of low bloods sugar and include tiredness, weakness, tremulous and hunger. Many patients have to eat frequently to prevent symptoms from the low blood sugar. Some patients may develop psychiatric symptoms because of the low blood sugar. How is the diagnosis is made? The diagnosis is made by simultaneous measurements of blood sugar and insulin levels in the blood. A low blood sugar with a high insulin level confirms the diagnosis. Once the diagnosis made based on the biochemical analysis then the physician will perform further studies to detect the tumor in the pancreas. Since most of these tumors are small, detection of the tumor in the pancreas may be difficult. Some of the studies that are performed to detect the tumor include a detailed CT scan, MRI, octreotide scan, and an endoscopic ultrasound. An experienced surgeon often detects these tumors even where they are not seen on radiological testing prior to surgery. Imaging the pancreas during the surgery directly with an ultrasound detects the majority of these tumors. How is insulinoma treated Insulinoma is a benign tumor of the pancreas in 90% of patients and removal of the tumor cures the patient of the symptoms. Surgical removal of the tumor is the treatment of choice. More than 90% of patients will not require any further treatment after removal of the tumor. The operations that are usually performed for Continue reading >>
Insulinomas are the most common cause of hypoglycemia resulting from endogenous hyperinsulinism. Approximately 90-95% of insulinomas are benign, and long-term cure with total resolution of preoperative symptoms is expected after complete resection.  See the image below. Signs and symptoms Insulinomas are characterized clinically by the Whipple triad, as follows: Presence of symptoms of hypoglycemia (about 85% of patients) Documented low blood sugar at the time of symptoms About 85% of patients with insulinoma present with one of the following symptoms of hypoglycemia: Hypoglycemia can also result in the following: Adrenergic symptoms (from hypoglycemia-related adrenalin release): Weakness, sweating, tachycardia, palpitations, and hunger See Clinical Presentation for more detail. Diagnosis Lab studies Failure of endogenous insulin secretion to be suppressed by hypoglycemia is the hallmark of an insulinoma. Thus, the finding of inappropriately elevated levels of insulin in the face of hypoglycemia is the key to diagnosis. The biochemical diagnosis of insulinoma is established in 95% of patients during prolonged fasting (up to 72 h) when the following results are found: Serum insulin levels of 10 µU/mL or more (normal < 6 µU/mL) C-peptide levels exceeding 2.5 ng/mL (normal < 2 ng/mL) Proinsulin levels greater than 25% (or up to 90%) of immunoreactive insulin levels Imaging studies Insulinomas can be located with the following imaging modalities: Real-time transabdominal high-resolution ultrasonography: 50% sensitivity Intraoperative transabdominal high-resolution ultrasonography with the transducer wrapped in a sterile rubber glove and passed over the exposed pancreatic surface: Detects more than 90% of insulinomas Computed tomography (CT) scanning: 82-94% sensitivity Continue reading >>
Insulinomas In Ferrets
By Rick Axelson, DVM Diagnosis, Medications, Medical Conditions, Surgical Conditions, Treatment, Tumors What is insulinoma? An insulinoma is a tumor that involves the beta cells of the pancreas. Beta cells are the cells that produce the hormone insulin. Insulinomas are surprisingly common in ferrets. An insulinoma may be an insulin-producing adenoma or an insulin-producing adenocarcinoma. By definition, an adenoma is benign, while an adenocarcinoma is malignant. Insulin regulates blood sugar levels by reducing the amount of glucose in the blood. Glucose is an important energy source for the body. The excess insulin that is produced by an Insulinoma results in dangerously low levels of glucose in the blood. The average age for a ferret to develop an insulinoma is 5 years old, but it may be seen as early as 2 years of age. What are the signs of an insulinoma? Clinical signs may include pawing at the mouth, "stargazing", weakness (often seen in the hind end), weight loss, tremors, collapse, abnormal behavior, depression, lethargy, and confusion. The symptoms can progress to include seizures and hypoglycemic (low blood sugar) coma. The adrenal gland reacts to dramatic reductions in blood glucose by producing adrenaline; increased levels of adrenaline cause a rapid heart rate, tremors and irritability. Some ferrets with tumors of the pancreas show no obvious clinical signs or may show only intermittent signs. If a ferret has intermittent episodes of hypoglycemia, the disease may go undetected for a prolonged time because the symptoms are not observed by the pet owner. The severity of clinical signs depends on how low the blood glucose gets and will often be better if the ferret has just eaten. How is an insulinoma diagnosed? "All too often ferrets with insulinomas have norma Continue reading >>
Why Did Steve Jobs Choose Not To Effectively Treat His Cancer?
I hesitated a long time before addressing this topic, but now that someone asked me to, I'll just do it. To avoid any risks of bias, let me start by stating that all the details on Jobs' specific case are based on secondary sources, albeit from reliable sources in the media. I write this on a personal title, I do not pretend to know anything about the case on a personal level and I never participated in the care of Mr. Jobs. I base all my cancer figures on sources from biomedical research known to me. I respect the privacy of, and in no way wish to offend, anyone mourning his passing. I have the profoundest respect for Mr. Jobs and his legacy but I feel that in the spirit of his progressive view of the world, learning from his case is an appropriate way to look back on the facts concerning his life and legacy. I have done 1.5 years of research on the type of tumor that affected Steve Jobs as a medical student in Amsterdam and have some strong opinions on his case, not only as an admirer of his work, but also as a cancer researcher who has the impression that his disease course has been far from optimal. Let me cut to the chase: Mr. Jobs allegedly chose to undergo all sorts of alternative treatment options before opting for conventional medicine. This was, of course, a freedom he had all the rights to take, but given the circumstances it seems sound to assume that Mr. Jobs' choice for alternative medicine could have led to an unnecessarily early death. Again, please understand that I have no knowledge of the specific case, I'm just trying to give insights on his a priori odds of cure. These are independent of his case and mere indicators that somehow his case turned for the worse when it statistically was improbable. What made this happen will remain in the domain of spe Continue reading >>
Do Doctors Know When Their Patient Is Lying?
Perhaps they know if their patient is lying. I think that more often, they assume that since they aren’t seeing anything on a test that the patient is imagining that their symptoms are worse than they are. In my case, I was ill a lot as a child in school. I complained of being very, very tired after being active for a while. Pain in my chest became a problem. My pediatrician found nothing wrong and told my mom that “some people are more sensitive than others and feel pain where other people would just ignore it.” In my 20s, I had unusual results on every EKG that I took prior to any kind of surgery. No one ever mentioned it to me or my family. In my 30s, I began to run a slight fever all the time. I began to feel out of rhythm heartbeats. Again, testing found nothing except that I had a little high white blood count that they said caused the fever (99–100). I was told that everyone has heartbeats that are unusual at times. In my 40s, I was very, very ill with throwing up, heaving, not being able to eat yet I didn’t lose any weight, wheezing, stomach pain, cough, and extreme weakness. I was sent to a gastroenterologist who tested but found nothing very unusual. One day I began peeing pure blood and felt like I was literally going to die. I was admitted to the hospital for kidney issues, but again they found nothing in their tests. I was put on an anxiety medication along with ulcer medications. Shortly after, still having symptoms, I was sent to a general surgeon who found a very enlarged gall bladder. Surgery was delayed, though, becuase the EKG showed irregularities and the doctor was concerned about putting me under general anesthesia. I had to sign a waiver saying that I knew there was a danger but I agreed to the anesthesia anyway. Not once did anyone sugg Continue reading >>
What Is Insulinoma?
Pancreatic beta cell tumor or insulinoma, is a common disorder in ferrets over 3 years of age. The small clusters of cells in the pancreas that normally produce insulin become abnormal (cancerous) and begin to produce excessive amounts of insulin. The normal job of insulin is to drive blood sugar (glucose) into the cells following a meal. Too much insulin will result in too much sugar leaving the bloodstream. This results in hypoglycemia that can ultimately become life-threatening in the affected ferret.
Pancreatic Cancer (insulinoma) In Dogs
Insulinoma in Dogs Insulinomas are malignant neoplasms -- fast growing cancer cells -- of the beta cells in the pancreas. The beta cells primarily secrete insulin, among other hormones. Insulin produces a variety of effects in the body -- the primary one being to regulate glucose levels throughout the body's cells. Because insulinomas secrete excessive insulin, the blood stream becomes low in glucose (a condition referred to as hypoglycemia), which causes weakness or neurological problems. Symptoms and Types The most common symptom of an insulinoma is physical collapse, or loss of consciousness (syncope). Seizures, extreme weakness, and other neurological abnormalities are also common. Because the insulin is released periodically, symptoms are not consistent and frequency is not necessarily predictable. Diagnosis If your dog should collapse and a blood sample indicates low glucose, insulinoma will be highly suspected and your veterinarian will need to follow through with further tests to confirm it. However, multiple blood samples may need to be taken over a period of time to determine if there is a persistent low glucose concentration. Your doctor will need to determine the insulin concentration at the lowest glucose concentration. Withold food from your dog before tests are performed is essential for determining true glucose levels - your veterinarian will advise you on the appropriate way to conduct these short term fasts for your dog. An amended insulin:glucose ratio (AIGR) may be useful when your dog's insulin level is low, yet still in the normal range. Insulinoma is still suspected in these type of cases. If the insulin level is inappropriately high for the decreased glucose level, insulinoma may still be present. Ultrasound, computed tomography (CT), or magnetic Continue reading >>
Insulinoma: Causes, Symptoms, Treatment, Diagnosis
Insulinoma is the name that refers to a small tumor that develops in the pancreas which is responsible for producing high amounts of insulin. In majority of the cases, Insulinoma is a benign tumor but in some cases it can become malignant. Insulinoma tumors are extremely small and measure not more than 2 cm in diameter. The blood sugar levels in the body are controlled by the pancreas. The pancreas produces insulin which decreases the sugar levels in the body and stops producing it when the sugar levels become lower than normal. This is how normal blood sugar levels are maintained in the body. What happens in case of Insulinoma is that even if the pancreas stops producing insulin, the tumor which develops in pancreas continues to produce insulin thus the blood sugar levels keeps on decreasing which may result in some potentially serious complications like hypoglycemia which can cause dizziness, blurred vision, and in some cases unconsciousness. If not treated promptly, it may even become life threatening. Treatment for Insulinoma is normally surgical where the tumor is removed in its entirety. Once the tumor is removed the affected individual completely recovers from Insulinoma. The exact cause of Insulinoma is still not yet known and most of these tumors develop without any warning signs. Once an Insulinoma develops then the normal functioning of the pancreas is affected. Normally, the pancreas regulates sugar levels in the body through insulin. The greater the amount of insulin the lesser will be the blood sugar level. Once all of the sugar from the food is absorbed by the body for their functions the pancreas stops producing insulin and thus controls the levels of sugar in the body but with Insulinoma the tumor continues to produce insulin which may lead to severe co Continue reading >>