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인슈린종의 진단과 치료에 대한 최근 견해 - 인슈린종 3예 보고 -

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Author(s)
손창용김유사이인규전석길
Keimyung Author(s)
Kim, You SahLee, In KyuZeon, Seok Kil
Department
Dept. of Surgery (외과학)
Dept. of Internal Medicine (내과학)
Dept. of Radiology (영상의학)
Journal Title
대한암학회지
Issued Date
1994
Volume
26
Issue
6
Abstract
Insulinoma is a functional endocrine tumor arising from beta cells of the isiets of Langerhans of the pancreas. The tumor is usually a benign, single adenoma and of small size (1-2 cm), and is evenly distributed throughout the pancreas. The symptoms and signs are triggered by hypoglycemia. Mechanisms for the production of symptoms are related to the neuroglycopenia causing cerebral dysfunction and the hypoglycemic stimulation of catecholamine release. Complex symptoms originating from these mechanisms frequently lead to misdiagnosis as a neurologic or psychiatric disorder and delay proper treatment.
Once suspicion of an insulinoma is made, the diagnosis is not complicated. Supervised fast until symptoms develop or for 72 hours bring the blood sugar level down below 50 mg/dl with inappropriately high endogenous insulin level. C-peptide and proinsulin fraction measured at the termination of the fast confirm the diagnosis.
Preoperative localization of a small insulinoma by ultrasonography, arteriograh or computed tomography is not always successful. Selective portal venous sampling for insulin has been found to be the most accurate method of localization. Careful exploration of the entire pancreas is very important at laparotomy and intraoperative ultrasonography is essential especially in identifying tumors in the head of the pancreas and in defining the relationship of the tumor to the pancreatic duct.
We report our experience of three patients with insulinoma during the last five year period: one male 23 years old and two females, 38 and 40 years old. Preoperative localization failed in the first patient but in two patients, preoperative percutaneous transhepatic portal venous sampling for insulin helped to localize the tumor. A relatively well-demarcated mass lesion was found in each patient, and all three patients were treated with successful outcome. The sizes of the tumors were 1.5 x 1.0 x 1.0 cm, 2.7 x 2.2 x1.4 cm, 1.5 x 1.0 x 1.0 cm respectively.
Alternative Title
Current Concepts of Diagnosis and Management of Insulinoma -Report of three cases of Insulinoma from Keimyung University Dongsan Hospital-
Keimyung Author(s)(Kor)
김유사
이인규
전석길
Publisher
School of Medicine
Citation
손창용 et al. (1994). 인슈린종의 진단과 치료에 대한 최근 견해 - 인슈린종 3예 보고 -. 대한암학회지, 26(6), 997–1004.
Type
Article
ISSN
0496-6872
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/38103
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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