Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ribosome-lamellae complexes (RLCs) were identified in approximately 20% of the tumor cells from a functional insulinoma studied by electron microscopy. Whereas these peculiar cytoplasmic inclusions are commonly seen in hairy cell leukemia (HCL) and can be present in a few cells in other hematologic disorders, to our knowledge they have never been documented in insulinoma. In fact, they are exceedingly rare in epithelial tumors. A review of the literature uncovered only two instances, one in an adenoma of the adrenal cortex, and one in a paraganglioma. In these two cases and in the insulinoma reported here, RPCs tend to be longer, have fewer lamellae, and occur in greater numbers per single cell than in HCL. Although the nature and significance of RLCs remain poorly understood, the fact that all three epithelial neoplasms in which they have been observed belong to the endocrine system is noteworthy.
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PMID:Ribosome-lamellae complexes in a symptomatic insulinoma. An ultrastructural study. 628 Jun 36

The patient study has been performed in order to evaluate the usefulness of the artificial pancreas in the surgical management of previously not localized insulinomas. In the 4 patients studied, blood glucose was maintained both overnight and during surgery up to a preselected individualized level in order to avoid hypoglycemia. During surgery, only one patient required dextrose infusion. The continuous intrasurgical monitoring of blood glucose in the 4 cases examined showed that: (1) anesthesia induction, surgical incision and viscera mobilization were accompanied by a rise in blood glucose (10.30 mg/dl), reaching the highest levels 30-40 min after the start of the operation; (2) adenoma manipulation was followed by a drop in blood glucose (10.40 mg/dl), reaching the lowest level after 30-40 min; (3) adenoma resection was followed by a rise in blood glucose (25-40 mg/dl), particularly evident after 30-40 min. It is concluded that the artificial pancreas is certainly useful during surgery of insulin-producing tumors, allowing continuous monitoring of glycemia and avoiding dangerous blood glucose excursions: however, when the insulinoma is not identified during surgery, the periods elapsing between the surgical phases and the blood glucose changes observed can be too prolonged to ensure successful conservative serial pancreatectomy in all cases.
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PMID:To what extent does the artificial pancreas facilitate the surgery of preoperatively not localized insulinomas? 629 44

Plasma insulin immunoreactivity (IRI) results from high molecular weight substances with insulin immunoreactivity (HWIRI), proinsulin (PI) and insulin (I). Their respective concentrations and percentages of IRI were determined preoperatively in the hepatic and peripheral circulations and after surgery in the latter two and in the portal circulation in a patient with a pancreatic adenoma. Removal of the insulinoma resulted in a highly significant reduction of PI concentration in the hepatic (from 16.2 +/- 1.9 microU/ml to 7.3 +/- 0.8 microU/ml) and in the peripheral (from 24.0 +/- 2.0 microU/ml to 9.2 +/- 1.2 micro U/ml) venous systems. Similarly, I concentration decreased in the hepatic (from 36.9 +/- 3.4 microU/ml to 28.0 +/- 1.0 microU/ml) and peripheral (from 33.8 +/- 3.4 microU/ml to 19.8 +/- 2.0 microU/ml) venous systems. HWIRI concentration decreased in the hepatic venous system (from 6.9 +/- 0.8 microU/ml, to 4.8 +/- 0.6 microU/ml), but the decrease in the peripheral venous system (from 9.7 +/- 1.4 microU/ml to 8.2 +/- 1.2 microU/ml) was not significant. It was found that the concentration of I virtually was the same in hepatic and peripheral blood prior to operation in contrast to a decrease seen after the operation. This indicates that the hyperinsulinemia caused primarily by the autonomous hypersecretion of the insulinoma was amplified by a decreased degradation of insulin by the liver and kidney. Our results also indicate that HWIRI was found with the highest concentration in the peripheral blood independently of the adenoma.
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PMID:Portal, hepatic and peripheral insulin immunoreactive substances before and after removal of an insulinoma. 629 20

A case of malignant insulinoma in a Black patient is presented. An investigational protocol is suggested with a discussion of the newer techniques of pancreatic adenoma localization and the therapeutic measures available for the management of malignant islet cell tumours.
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PMID:Malignant insulinoma: the problems of tumour localization and management. A case report. 630 27

The diazoxide infusion test (600 mg i.v. over a 1-hour period) was performed in 12 patients bearing single benign islet B-cell adenoma and in 6 normal subjects. Blood glucose, plasma insulin and glucagon concentrations were measured every 15 min during the infusion and thereafter up to 150 min. In insulinoma patients, blood glucose levels failed to increase significantly while in the control group a significant rise starting from 30 min persisted throughout the test (p less than 0.05 or less). Plasma insulin mean levels decreased significantly in normal subjects from 30 to 60 min (p less than 0.05), while they were significantly suppressed in hypoglycemic patients from 15 to 120 min (p less than 0.02). Diazoxide administration induced in the normal group a significant decrease in glucagon levels (p less than 0.02 from 30 to 150 min) whereas no such suppression occurred in patients. In our experience, insulin response to diazoxide infusion in patients with insulinoma may provide additional information for diagnosis.
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PMID:Diazoxide infusion test in patients with single benign insulinoma. 630 33

Hyperinsulinaemic hypoglycaemia in infancy may be transient or persistent. Persistent hypoglycaemia is caused by nesidioblastosis of the pancreas, a diffuse pancreatic endocrine abnormality involving all the endocrine tissue, or by an islet cell adenoma. The cause of nesidioblastosis is not known but unless controlled its hypoglycaemic effects lead to convulsions, mental retardation or death. Patients with transient hyperinsulinaemic hypoglycaemia, and some with persistent hypoglycaemia, respond to medical therapy but those with an adenoma and many of those with nesidioblastosis will require partial or total pancreatectomy. The surgical treatment of six infants and a child is discussed. Five infants had nesidioblastosis; one infant and one nine-year-old girl had an islet cell adenoma. It is suggested that in the very young when there is no evidence of an insulinoma, resection at the initial operation should be greater--up to 90 per cent--than the previously recommended 75 per cent.
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PMID:The surgical treatment of hyperinsulinism in infancy and childhood. 631 36

A 71-year-old woman with insulinoma was studied. Preoperatively, using the glucose controlled insulin infusion system (GCIIS) for glucose clamping at various blood glucose levels, autonomous insulin production was demonstrated and intravenous glucose needs for maintenance of normoglycaemia were evaluated. The results of a somatostatin suppression test, guided by the GCIIS, supported the postulation of a well differentiated beta cell adenoma with reduced storage capacity. These assumptions were later confirmed by histochemical and ultrastructural investigations. Hypoglycaemia during surgery was avoided by means of the GCIIS. Upon clamping of the plasma glucose at 90 mg/dl, 15.5 g dextrose had to be given until resection of the tumour. Immediately thereafter, a sharp rise in plasma glucose to 140 mg/dl together with a need for 4.1 U insulin showed that the insulinoma tissue had been removed completely.
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PMID:[Diagnosis and surgery of an insulinoma using a glucose-controlled insulin infusion system]. 632 14

Because of the danger of irreversible brain damage in children, effective therapy for hypoglycaemia must be initiated as rapidly as possible. If drug therapy fails, only surgery remains after thorough metabolic, endocrinological and radiological investigations to completely cure B-cell adenoma. I conclude with a quotation from Sauerbruch (15), who had successfully removed an insulinoma from a 7-year-old girl: If in medicine we can speak about causally induced disorders, then it is justified here. A tangible, anatomically unequivocal finding causes a localized disease, which disappears without trace after the removal of a small tumour. Other endocrine disorders cannot be detected with such convincing clarity and interpreted in the same way, nor can they be as successfully treated as this.
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PMID:Surgical operations on the pancreas in malignant disease in children. 634 83

A parathyroid adenoma occurred synchronously with a thymic carcinoid tumor in a 34-year-old man. A sibling was known to have an insulinoma, pituitary adenoma, and parathyroid hyperplasia. The simultaneous occurrence of these tumors, in association with the noted family history, suggests a possible multiple endocrine adenomatosis variant. A description of both tumors is provided along with a review of the literature on thymic carcinoid tumors.
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PMID:Carcinoid tumor of the thymus associated with a parathyroid adenoma. 707 13

We report herein a rare case of malignant insulinoma which recurred as multiple liver metastasis 8 years after the initial resection. The patient was a 51-year-old Japanese man who originally presented in 1985 at the age of 43 years suffering from general malaise and syncope. The initial surgery in 1985 involved complete enucleation of a 15 x 13 mm insulinoma located in the uncus of the pancreas. Histopathologically, the tumor was diagnosed as a benign adenoma (insulinoma) which was immunohistochemically stained with only the anti-insulin monoclonal antibody. Macroscopically, there were no signs of either invasion or metastasis. During the subsequent 7 years, he did not show any symptoms or significant abnormality in laboratory data. However, in 1993, the patient again experienced syncope with hypoglycemia and hyperinsulinemia. Ultrasonography revealed multiple echogenic lesions in the liver and a second laparotomy confirmed multiple hepatic metastases from insulinoma, the histopathological findings of which were similar to those of the primary tumor from 8 years before. The patient is currently being treated with streptozotocin and 5-fluorouracil via a catheter in the hepatic artery.
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PMID:Malignant insulinoma causing liver metastasis 8 years after the initial surgery: report of a case. 754 77


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