Adam Shared "Pancreatic Islet Tumors" - 3 Picmonics
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Pancreatic Islet Tumors
Glucagonoma
- Tumor of pancreatic α cells
- Overproduction of glucagon
- Diabetes (hyperglycemia)
- Declining weight
- Depression
- Anemia
- Dermatitis (necrolytic migratory erythema), typically affects the groin mostly (but also face/extremities)
- Blistering and scaling
- DVT
- Glossitis, cheilitis, blepharitis
- MEN 1 Association
- Treatment
- Octreotide
- Surgery
Insulinoma
- Tumor of pancreatic β cells
- Overproduction of insulin
- Hypoglycemia (tremor, confusion)
- Increased C peptide production
- 10% of cases associated with MEN 1 syndrome
- Whipple triad
- Symptoms of hypoglycemia (lethargy, syncope, diplopia)
- Low blood glucose
- Resolution of symptoms after normalization of glucose levels
- Treatment
- Surgery
Somatostatinoma
- Tumor of pancreatic δ cells
- Overproduction of somatostatin
- Decreased secretion of secretin, cholecystokinin, glucagon, insulin, gastrin
- Symptoms
- Diabetes/glucose intolerance
- Steatorrhea
- Gallstones because somatostatin decreases CCK secretion (decreased gallbladder contraction)
- Can be hyperglycemia or hypoglycemic
- Achlorhydria (due to inhibition of gastrin)
- Inhibiting GI motility
- Treatment
- Surgical resection
- Somatostatin analogs (eg, octreotide) for symptom control
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