Endocrine Abstracts (2006) 11 P441

Insulinomas – an experience from a tertiary care institution in South India

Thomas Vizhalil Paul, Nihal Thomas, Mandal Seshadri, K Senthilvasan, Evelyn Esther & K Sudeep

Christian medical college, Vellore, Tamil Nadu, India.

Background: Insulinoma is an uncommon disease. The clinical profile of insulinomas among Indian patients is not well known.

Aim of the study: To study the clinical characterstics, biochemical and radiological parameters,and treatment aspects of our adult patients with insulinomas.

Methodology: We did a retrospective analysis of 18 patients with insulinoma treated from 1992 to 2004 in our institution. The data was analysed using a 11.0 SPSS software package.

Results: The mean age of patients was 43.11 years (±15.24) with a male predominance. The commonest symptom was recurrent loss of consciousness, The mean fasting plasma glucose was 34.22 mg % (±5.82). The mean insulin glucose ratio was 1.67 (±1.08). Two patients had features of MEN I syndrome (11 percent). Fourteen patients underwent surgery and four patients opted for medical treatment. All the tumours that were identifiable histologically were palpable intraoperatively. Histopathology was positive in 10 out of 14 patients. All patients except one were found to have benign lesions on histopathology. The most common site of tumour location was in the head and uncinate process of the pancreas. Preoperative tumour localization was possible in 11 out of 14 (79 percent) patients.

Computerised Tomography had a sensitivity of 62.5% and positive predictive value of 100% in localizing tumors. In 12 patients out of 14 patients who underwent surgery sugars normalized. Two out of four patients who are taking medical treatment are asymptomatic and remaining 2 patients are lost in follow up.

Conclusions: In our series, Insulinoma has a male predominance and preoperative localization was 79 percent in the patients who underwent surgery with various imaging techniques.

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