Endocrine pancreatic tumor is diagnosed by any medical technique?

This is an automatically translated article.

The article was professionally approved by Master, Doctor Luu Thi Bich Ngoc - Radiologist - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International General Hospital.

The diagnosis of endocrine pancreatic tumor is based on the quantification of blood sugar during hypoglycemia, high endogenous insulin, imaging methods will help locate endocrine pancreatic tumor useful for surgery. art.

1. Overview of endocrine pancreatic tumors

The pancreas is an organ located in the abdomen, behind the peritoneum, which plays an important role in the human body. The pancreas belongs to the digestive system with the following functions:
Exocrine: secretes digestive juices to help digest food. Endocrine: secretes hormones that help regulate blood sugar. Therefore, any damage to the pancreas affects its ability to regulate hormones. Endocrine pancreatic tumor (Insulinoma) is a condition in which tumors have the ability to secrete insulin hormone leading to an excess of pancreatic hormone in the body, endothelial dysfunction, difficulty in controlling blood sugar index, digestive juices .
However, endocrine pancreatic tumors are quite rare with an incidence of 1-4 cases per million people and only 7% of all pancreatic cancers. Although noninvasive and only 10% are malignant, in contrast endocrine pancreatic tumors have a high and rapid mortality rate.

2. Signs to recognize endocrine pancreatic tumors

Characteristic signs to help identify endocrine pancreatic tumors include:
Low blood sugar when fasting, or after eating (due to insulin secretion). Central nervous system disorders (due to lack of glucose in the brain) such as headache, confusion, insomnia, visual disturbances, myasthenia gravis, paralysis, personality changes, may even lead to loss of consciousness , seizures and coma. Signs of sympathetic stimulation such as fatigue, dizziness, tremors, palpitations, sweating, hunger and anxiety... often appear. Symptoms can range from 1 week to several decades before diagnosis. Symptoms also occur frequently at night or early in the morning and tend to be aggravated by exercise, alcohol consumption, a reduced-calorie diet, and sulphonamide-lowering blood sugar treatment.
Symptoms of endocrine pancreatic tumors can be difficult to diagnose because they resemble many other neurological and psychiatric conditions.

3. Diagnosis of endocrine pancreatic tumors

To diagnose endocrine pancreatic tumors, the doctor will combine with medical history, physical examination and perform in-depth tests. The doctor will monitor the typical signs of the disease based on the Whipple triad (especially for people who have lost weight or have digestive symptoms) including:
Signs of low blood sugar: Anxiety, shaking, sweating, hunger, fatigue, blurred vision (double vision, blurred vision), dizziness, loss of consciousness, coma, convulsions. Low blood sugar <= 40mg/dl (<= 40 x 5.5/100 = 2.2mmol/l) Immediate recovery after using Glucose.

4. What medical techniques should be used to diagnose endocrine pancreatic tumors?

For patients with no symptoms (and no hypoglycemia), the doctor will measure blood sugar and insulin levels when the patient has fasted for 48 hours, 72 hours. Nearly all (98%) of patients with endocrine pancreatic tumors will develop symptoms within 48 hours of fasting.
In addition, some other medical tests may be ordered and applied depending on the condition of each patient and the assessment of the doctor. Tests include:
Blood tests: to look for excess hormones or other signs of an endocrine pancreatic tumor. Urinalysis: reveals breakdown products as the body processes hormones. Imaging tests: help look for abnormalities in the pancreas and identify tumors. Imaging tests such as endoscopic ultrasound (>90% sensitivity), CT and magnetic resonance imaging (MRI), and positron emission tomography (PET) may also be used. Biopsy: Using an approach technique, a small sample of tumor cells (tissue sample) is taken for testing. This procedure is not a treatment, but only supports the diagnosis of endocrine pancreatic tumors. Endocrine pancreatic tumors are rare, but the clinical presentation is diverse, making it easy to be misdiagnosed with other neurological diseases (epilepsy or psychosis). Patients with a history of neurological disorders, or fatigue and discomfort, especially after meals, need special attention.
Due to the heavy endocrine influence, pancreatic neuroma, if not detected and treated properly, will cause permanent damage to the patient's central nervous system, difficult to recover, leading to some sequelae. severe nerves.
Currently, Vinmec International General Hospital has been and continues to be fully equipped with modern diagnostic facilities such as: PET/CT, SPECT/CT, MRI, X-ray, ultrasound, as well as fully equipped enough tests to perform examination and diagnosis of medical conditions, including endocrine pancreatic tumors. The entire examination process at Vinmec is performed by a team of experienced and qualified medical professionals, so the results are accurate, and the patient has the opportunity to receive early treatment to ensure long-term health.

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