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Abstract：
Insulinoma is a rare pancreatic neuroendocrine tumor with an incidence of 1-4 cases per million. Here we present our 10 years of experience in 13 cases of insulinoma. We retrospectively reviewed all insulinoma patients diagnosed and treated between 2012 and 2022. Clinical and pathological features, diagnostic methods, and follow-up results of insulinoma patients were discussed. A total of 13 patients were included in this study (7 men, and 6 women). The mean age at the time of diagnosis was 58 (36.5-70.5) years. There is only one patient diagnosed with MEN-1 syndrome. The mean time from the onset of symptoms to the diagnosis was 15 (7-27.5) months. In the prolonged fasting test, symptomatic hypoglycemia occurred in all patients within 48 h. The median size of lesions was 15 (12-24) mm, and 46.2% of these lesions were isolated in the pancreatic tail. Ga-68 DOTATATE PET/CT detected lesions with 100% accuracy. Three patients met the criteria for malignant insulinoma. Octreotide LAR was given to 1 patient with metastatic disease and 1 patient who did not accept surgery. The metastatic patient received 8 cycles of Lu treatment and died after 51 months of follow-up. The diagnosis of insulinoma can be challenging. The 48-h fasting test period provided sufficient information for the diagnosis of insulinoma. Ga-68 DOTATATE PET/CT may be an alternative in cases where cross-sectional imaging cannot localize the pancreatic lesion.
摘要：
胰岛素瘤是一种罕见的胰腺神经内分泌肿瘤，发病率为1-4例/百万。在这里，我们介绍了13例胰岛素瘤的10年经验。我们回顾性回顾了2012年至2022年间诊断和治疗的所有胰岛素瘤患者。临床和病理特征，诊断方法,并对胰岛素瘤患者的随访结果进行讨论。本研究共纳入13名患者(7名男性，和6名妇女）。诊断时的平均年龄为58（36.5-70.5）岁。只有一名患者被诊断患有MEN-1综合征。从症状发作到诊断的平均时间为15（7-27.5）个月。在长时间的空腹测试中，所有患者在48h内发生症状性低血糖。病灶的中位大小为15（12-24）mm，这些病变中有46.2％分离在胰腺尾部。Ga-68DOTATATEPET/CT以100%准确度检测病变。3例患者符合恶性胰岛素瘤的标准。1例转移性疾病患者和1例未接受手术的患者给予奥曲肽LAR。转移性患者接受了8个周期的Lu治疗，随访51个月后死亡。胰岛素瘤的诊断可能具有挑战性。48小时的空腹测试期为胰岛素瘤的诊断提供了足够的信息。在横截面成像无法定位胰腺病变的情况下，Ga-68DOTATATEPET/CT可能是一种替代方法。
