Insulinoma

Insulinoma: tumor of the beta cells of the islets of Langerhans of the pancreas

Insulinoma is a rare tumor of the pancreas that causes excessive insulin secretion. The tumor forms in the beta cells of the islets of Langerhans, which are responsible for the synthesis and release of insulin. Excess insulin secretion leads to symptoms of hypoglycemia, which can be severe and life-threatening.

One of the most characteristic symptoms of insulinoma is excessive sweating, especially at night. Patients may also experience occasional loss of consciousness and fainting, especially after eating. This occurs due to a sharp decrease in blood glucose levels due to excess insulin production. Another characteristic feature of insulinoma is the symptoms of Whipple's Triad, which includes hypoglycemia, hyperinsulinism and β-cell hypertrophy.

The diagnosis of insulinoma can be difficult because symptoms may be nonspecific and occur sporadically. To confirm the diagnosis, various laboratory and instrumental studies are carried out. However, the main method is to conduct a test fast, during which the level of glucose and insulin in the patient's blood is measured.

Treatment for insulinoma depends on the size and location of the tumor. Single tumors, revealed

**Insulinoma** (lat. Insulinomas, turn involute tumor, endendocrinoma) is an insulin-producing tumor, which is insulin-secreting elements in the form of small cells separated by ducts. Initially, such cells are found only around the ducts, they do not form mucin, and after a few hours they tend to separate. The insulin value increases in parallel with the rate of cell separation. Then the separated cells circulate through the circulatory system and are fixed in various organs and tissues (skin, muscle, brain, eyes). These cells secrete large amounts of insulin, which is not bound by calcium ions in the blood, causing blood glucose levels to remain low.

**Causes of development:** Insulinomas are detected in 6% of cases. This is a rare tumor disease. Men get sick more often than women in the period from 40 to 60 years. Flooding of the gland with insulin does not appear immediately, since the glucose necessary for the functioning of the islets of endocrine cells comes from the bloodstream, i.e., from the opposite part of the pancreas, where there is no formation of secretory substances. The formation of insulin granules in the pancreas is blocked by the entire tumor mass. And the formation of a granular mass includes extra-microscopic, specific changes that contribute to complete coverage of the area of ​​the functioning part of the gland. As a result, the morphological picture depends on the number of insulin-secreting structures. With minimal histological changes throughout the affected area of ​​the gland, foci of acidophilic eosinophilic hepatosis predominate. The larger the defective gland tissue and, accordingly, insulin and beta-cell islets, the greater the degree of granularity in all tissue areas patients have. Accordingly, the more insulin enters the body from the liver, the less glucose is reflected back into the blood. These processes are interconnected, although they are in opposite directions. Thus, the glucose concentration can decrease to a critical level, which can cause a fainting state, which many patients suffer until the examination is carried out to diagnose the pathology and determine the necessary treatment tactics.

In most cases, the causes of tumor growth are:

family or hereditary genetic factors; provocateurs of pathological processes in the body are environmental factors that significantly stimulate the synthesis and production of excess insulin - these are stressful situations of a physical, psychological or chemical nature, smoking, fasting; repeated sharp decreases and increases in blood sugar levels through disruption of the functioning of gland cells; abuse of alcohol, drugs, chemical products; diseases of the pancreas and endocrine system.