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− | ==Description== | + | ==Introduction== |
| [[Image:Islet cell tumour.jpg|right|thumb|100px|<small><center>Islet cell tumour (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]] | | [[Image:Islet cell tumour.jpg|right|thumb|100px|<small><center>Islet cell tumour (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]] |
| '''Insulinomas''' are slow growing, well-encapsulated, functional tumours of the [[Pancreas - Anatomy & Physiology#Endocrine|beta cells]] of the pancreatic islets. They secrete inappropriately high amounts of [[Pancreas - Anatomy & Physiology#Insulin|insulin]], irrespective of the serum glucose concentration. They are often malignant, with a high metastatic rate to regional lymph nodes, [[Liver - Anatomy & Physiology|liver]] and omentum. 60% of insulinomas are carcinomas, which are more likely to be endocrinologically active whereas the others are adenomas. | | '''Insulinomas''' are slow growing, well-encapsulated, functional tumours of the [[Pancreas - Anatomy & Physiology#Endocrine|beta cells]] of the pancreatic islets. They secrete inappropriately high amounts of [[Pancreas - Anatomy & Physiology#Insulin|insulin]], irrespective of the serum glucose concentration. They are often malignant, with a high metastatic rate to regional lymph nodes, [[Liver - Anatomy & Physiology|liver]] and omentum. 60% of insulinomas are carcinomas, which are more likely to be endocrinologically active whereas the others are adenomas. |
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| A '''partial pancreatectomy''' is suitable for patients with a solitary tumour and any suspected metastases may be removed or biopsied during the procedure. An intra-operative ultrasound scan can be performed if the mass is not evident when the pancreas has been exposed. Possible post-operative complications include: | | A '''partial pancreatectomy''' is suitable for patients with a solitary tumour and any suspected metastases may be removed or biopsied during the procedure. An intra-operative ultrasound scan can be performed if the mass is not evident when the pancreas has been exposed. Possible post-operative complications include: |
| *'''Persistent hypoglycaemia''', probably due to the presence of unidentified metastases. | | *'''Persistent hypoglycaemia''', probably due to the presence of unidentified metastases. |
− | *[[Pancreatitis - Dog and Cat|'''Pancreatitis]]''' or '''[[Diabetes Mellitus|Diabetes mellitus]]''' due to disruption to the pancreatic parenchyma during the procedure. | + | *[[Pancreatitis|'''Pancreatitis]]''' or '''[[Diabetes Mellitus|Diabetes mellitus]]''' due to disruption to the pancreatic parenchyma during the procedure. |
| *'''Epilepsy''' and '''diffuse polyneuropathy''' due to chronic hypoglycaemia. | | *'''Epilepsy''' and '''diffuse polyneuropathy''' due to chronic hypoglycaemia. |
| *'''Duodenal necrosis and perforation''' as the cranial pancreatico-duodenal artery may be disrupted when the right limb of the pancreas is dissected away from the duodenum. | | *'''Duodenal necrosis and perforation''' as the cranial pancreatico-duodenal artery may be disrupted when the right limb of the pancreas is dissected away from the duodenum. |
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| This is related to the WHO stage of the tumour at diagnosis. An animal with a stage I and II neoplastic process could expect a median survival time of 18 months but this falls to only 6 months for an animal with stage III disease. Patients which undergo surgery to remove an insulinoma have a better prognosis than those treated medically but the condition will recur invariably after surgical removal. Those animals which show a recurrence of clinical signs after surgery may then be treated medically, an approach that produces a significant increase in median survival time (from approximately 2 years to 4 years). | | This is related to the WHO stage of the tumour at diagnosis. An animal with a stage I and II neoplastic process could expect a median survival time of 18 months but this falls to only 6 months for an animal with stage III disease. Patients which undergo surgery to remove an insulinoma have a better prognosis than those treated medically but the condition will recur invariably after surgical removal. Those animals which show a recurrence of clinical signs after surgery may then be treated medically, an approach that produces a significant increase in median survival time (from approximately 2 years to 4 years). |
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− | ==Literature Search== | + | {{Learning |
− | [[File:CABI logo.jpg|left|90px]]
| + | |Vetstream = [https://www.vetstream.com/felis/Content/Disease/dis02122.asp Insulinoma] |
− | | + | |literature search = [http://www.cabdirect.org/search.html?rowId=1&options1=AND&q1=Insulinoma&occuring1=title&rowId=2&options2=AND&q2=&occuring2=freetext&rowId=3&options3=AND&q3=&occuring3=freetext&x=44&y=8&publishedstart=yyyy&publishedend=yyyy&calendarInput=yyyy-mm-dd&la=any&it=any&show=all Insulinoma publications] |
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− | Use these links to find recent scientific publications via CAB Abstracts (log in required unless accessing from a subscribing organisation).
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− | [http://www.cabdirect.org/search.html?rowId=1&options1=AND&q1=Insulinoma&occuring1=title&rowId=2&options2=AND&q2=&occuring2=freetext&rowId=3&options3=AND&q3=&occuring3=freetext&x=44&y=8&publishedstart=yyyy&publishedend=yyyy&calendarInput=yyyy-mm-dd&la=any&it=any&show=all Insulinoma publications] | |
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| ==References== | | ==References== |
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| [[Category:Pancreas_-_Hyperplastic_and_Neoplastic_Pathology]][[Category:Endocrine_System_-_Pathology]] | | [[Category:Pancreas_-_Hyperplastic_and_Neoplastic_Pathology]][[Category:Endocrine_System_-_Pathology]] |