An insulinoma case

Abstract

Hormone-active beta-cell adenoma of the pancreatic Langerhans Islands, or insulinoma — is a relatively rare disease (1:10,000). In the domestic literature, 282 cases were reported, of which in 19 cases the tumor had a malignant character. The complexity of disease recognition is confirmed by the fact that 1/3 of all publications are sectional findings. The tumor produces insulin in large quantities, which causes hypoglycemic attacks. These hormonal and metabolic disorders are the basis of the clinical picture of the disease, which is often dominated by disorders of a neuropsychiatric nature, due to the special sensitivity of nerve cells of the brain to a lack of glucose. Diagnosis of the disease is very difficult. The period from the appearance of the first clinical symptoms to the establishment of a correct diagnosis ranges from 2 to 20 years. For a long time, due to the General nature of symptoms, patients are observed in therapists, neuropathologists, psychiatrists with diagnoses of epilepsy, neuroses, psychoses, organic brain lesions, etc.there Are the most characteristic signs, United by the Whipple triad: a) the development of neuropsychic disorders with loss of consciousness on an empty stomach or after exercise; b) hypoglycemia below (40 mg%, 2.22 mmol/l) during the attack; C) rapid relief of the attack by intravenous glucose or taking sugar. Due to the diversity of the clinic, the rarity of the described disease, the difficulty of diagnosis, the description of each clinical observation is of interest.