Malignant insulinoma: Can we predict the long-term outcomes?

Scientific paper - Review paper

• Author: Maja Cigrovski Berković
• Author: Monika Ulamec
• Author: Sonja Marinović
• Author: Ivan Balen
• Author: Anna Mrzljak
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract (english)

Insulinomas are the most frequent type of functional pancreatic neuroendocrine tumors with a variety of neuroglycopenic and autonomic symptoms and well-defined diagnostic criteria; however, prediction of their clinical behavior and early differentiation between benign and malignant lesions remain a challenge. The comparative studies between benign and malignant cases are limited, suggesting that short clinical history, early hypoglycemia during fasting, high proinsulin, insulin, and C-peptide concentrations raise suspicion of malignancy. Indeed, malignant tumors are larger with higher mitotic count and Ki-67 proliferative activity, but there are no accurate histological criteria to distinguish benign from malignant forms. Several signaling pathways have been suggested to affect the pathophysiology and behavior of insulinomas; however, our knowledge is limited, urging a further understanding of molecular genetics. Therefore, there is a need for the identification of reliable markers of metastatic disease that could also serve as therapeutic targets in patients with malignant insulinoma. This opinion review reflects on current gaps in diagnostic and clinical aspects related to the malignant behavior of insulinoma.

• Keywords (english): Liver; Malignant insulinoma; Pancreatic neuroendocrine tumor; Resection; Transplantation
• Language: english
• Publication type: Scientific paper - Review paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: World Journal of Clinical Cases
• Numbering: vol. 10, no. 16, pp. 5124-5132
• p-ISSN: 2307-8960
• DOI: https://doi.org/10.12998/wjcc.v10.i16.5124
• URN:NBN: urn:nbn:hr:105:074203
• Publication: 2022
• Document URL: https://www.wjgnet.com/2307-8960/full/v10/i16/5124.htm
• Type of resource: Text
• Access conditions: Open access
• Created on: 2023-04-18 12:01:55