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

Cigrovski Berkovic, Maja; Ulamec, Monika; Marinović, Sonja; Balen, Ivan; Mrzljak, Anna (2022) Malignant insulinoma: Can we predict the long-term outcomes?. World Journal of Clinical Cases, 10 (16). pp. 5124-5132. ISSN 2307-8960

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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.

Item Type: Article
Uncontrolled Keywords: Pancreatic neuroendocrine tumor ; Malignant insulinoma ; Resection ; Liver ; Transplantation
Subjects: BIOMEDICINE AND HEALTHCARE > Clinical Medical Sciences
INTERDISCIPLINARY AREAS OF KNOWLEDGE > Biotechnology in Biomedicine (natural science, biomedicine and healthcare, bioethics area
Divisions: Division of Molecular Medicine
Depositing User: Sofija Konjević
Date Deposited: 01 Aug 2022 10:30
DOI: 10.12998/wjcc.v10.i16.5124

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