MALIGNANT INSULINOMA

Abstract

Insulinomas are rare neuroendocrine tumours of the GIT with an incidence of 1-4/million1. They are the most common cause of hypoglycemia due to endogenous hyperinsulinemia. In 1927, Wilder established the association between hyperinsulinism and functional islet cell tumour2. Insulinomas have been misdiagnosed as psychiatric or seizure disorders. They secrete insulin in addition to a large no of other hormones like gastrin, ACTH and Glucagon etc. Most are benign i.e. >90%, so the malignant are even more rare. About 10 % are multiple; out of which 50% are associated with MEN 1. Most of the symptoms are due to hypoglycemia and include altered behavior/consciousness. The genetics include mutations on MEN 1 on hromosome 11 and Kras3.