Video není dostupné.
Omlouváme se.
Functional pancreatic neuroendocrine tumors
Vložit
- čas přidán 18. 08. 2024
- This is a brief video on pancreatic neuroendocrine tumors that are functional and secreting excess hormones that have systemic effects.
I created this presentation with Google Slides.
Image were created or taken from Wikimedia Commons
I created this video with the CZcams Video Editor.
ADDITIONAL TAGS:
Functional pancreatic neuroendocrine tumors
“Islet cell tumorsâ€
Neoplasms that arise from the endocrine pancreas that actively secrete hormones to have systemic effects
Gastrinoma
Insulinoma
Glucagonoma
VIPoma
Somatostatinoma
Salt and pepper chromatin -- indicative of neuroendocrine differentiation
By Nephron - Own work, CC BY-SA 3.0, commons.wikime...
Gastrinoma
Second most common PNET
Gastrin secreting tumor of the endocrine pancreas (can also occur in the duodenum
Gastrin induces gastric acid secretion
Gastrin normally comes from G cells that are NOT found in endocrine pancreas
Causes recurrent ulcers in the stomach, duodenum, and jejunum (don’t usually get ulcers that far down)
Ulcers don't respond to conventional therapy
Presents with abd pain, diarrhea
Diagnose with failed suppression by secretin, which normally inhibits gastrin release; high blood gastrin levels
Treat with somatostatin (octreotide) or surgical resection
Causes Zollinger-Ellison syndrome
Gastrinoma
Insulinoma
Glucagonoma
VIPoma
Somatostatinoma
Insulinoma
Most common PNET
Insulin secreting tumor of the endocrine pancreas (beta cells)
Presents with hypoglycemia symptoms (hungry, nervous, sweating; progresses to lethargy, confusion, coma)
Whipple’s triad: hypoglycemia (sugar below 55), symptoms of hypoglycemia, symptoms corrected with administration of glucose
Bloodwork shows:
Low glucose
High insulin
High C-peptide
Unlike exogenous use
Pathology: usually small,
Treat with surgical resection
CC BY-SA 3.0, commons.wikime...
Gastrinoma
Insulinoma
Glucagonoma
VIPoma
Somatostatinoma
Glucagonoma
Rare tumor; often malignant
Glucagon secreting tumor of the endocrine pancreas (alpha cells)
Bloodwork shows increased glucagon, often increased glucose
Presents with
mild diabetes,
dermatitis called necrolytic migratory erythema,
decreased weight,
decreased RBCs (anemia),
venous thrombosis (DVT),
Treat with somatostatin (octreotide) or surgical resection
Gastrinoma
Insulinoma
Glucagonoma
VIPoma
Somatostatinoma
VIPoma
AKA Verner-Morrison syndrome
Rare tumor, most are malignant
VIP secreting tumor of the endocrine pancreas (D1 cells)
Vasoactive intestinal peptide (VIP)
Normal role in gut is to stimulate secretion of water and electrolytes
Presents as profuse and explosive and watery diarrhea
Results in low HCl (hypochlorhydria), low K, and dehydration
Gastrinoma
Insulinoma
Glucagonoma
VIPoma
Somatostatinoma
Somatostatinoma
Rare tumor, most are malignant
Somatostatin secreting tumor of the endocrine pancreas (D or delta cells)
Somatostatin inhibits: Gastrin, Cholecystokinin (CCK), Secretin, Motilin, Vasoactive intestinal peptide (VIP), Gastric inhibitory polypeptide (GIP), Enteroglucagon
Presents with mild diabetes, gallstones, steatorrhea, hypochlorhydria
Treat with somatostatin (octreotide) or surgical resection
Less common PNETs:
ACTHoma, CRHoma, calcitoninoma, GHRHoma, GRFoma, and parathyroid hormone–related peptide tumor
Gastrinoma
Insulinoma
Glucagonoma
VIPoma
Somatostatinoma
Multiple endocrine neoplasia
Gastrinoma
Insulinoma
Glucagonoma
VIPoma
Somatostatinoma
By Mikael Häggström - Own work, CC0, commons.wikime...
Why would you treat a somatostatinoma with octreotide? Don't we already have an overproduction of somatostatin?
Hey, I was wondering the same thing, and found this.
"Somatostatin also inhibits its own secretion from the periventricular nucleus [82]"
Source: www.sciencedirect.com/topics/medicine-and-dentistry/somatostatin-14
Yes same question
Otherwise nice video. The layout was very easy to follow and understand and your voice was easy to listen to.
Very informative. Thank you!
Thanks for your production. I have an appointment with endocrinology soon and I'm looking into the subject
Love your videos!
thank you for your great work sir. Can you please make a list of neuroanatomy videos? A lot of students are struggling with it and there are no good complete resources about it.
Thank you doctor this video helped me a lot 🙏🏻
I wish it would enter mainstream education when it comes to insulinomas that they can be reactive. Strictly reactive. And that would make it not fulfill the whipples triad. It keeps people is agony and suffering miserably being misdiagnosed when the solution is so easy and the prognosis so good.
Diazoxide is a way to inhibit an insulinoma if it’s not resectable or to keep it at bay until surgery. That’s important information too.
That info is very helpful
@Meesh Lathrom can you provide a link to research that supports insulinomas as reactive? I know your response is from two years ago so I hope you see this. I’ve only read they secrete intermittently and that the “on/off” mechanism is currently unknown. It makes sense that they would secrete in response to stress! I’m scheduled for a 72 hour fast in two days because insulinoma is suspected. I don’t think these functional tumors are as rare as current literature presents them to be.
Abigail Helton they don’t respond to stress. But to food. Look up “insulinomas presenting with reactive hypoglycemia”. Look up those exact words and you’ll find a ton of case studies.
Stress causing blood sugar woes is more of an adrenal insufficiency or even glycogen storage disease problem.
I tried Diazoxide but in america it only comes in the liquid form. Which is alcohol suspension. Alcohol drops my sugar levels fast. So it was counterproductive. The alcohol was stronger than the medicine. Diazoxide is a calcium channel blocker. So is magnesium. So I’m taking that instead. It upsets my digest track alittle bit. (Sulfuric smelling gas) But my sugars seem more stable. And it’s very cheap and easy to come by.
Meesh Lathrom thank you for your response. I’m going to read those case studies today. I would like to read more about your experience with insulinoma(s).
good explanation. thank you!
amazing video thank you
i have to eat every tow hours or i have severe hypoglycemia it goes away after i eat my blood sugar 90 at low 120 norm 180 high no one thinks i have insulinoma but me i cant get any help this has ruled my life for over 15 years i dont know what to do :(
Have d same thing..its crazy..severe blood lows ..have to rush and eat cause it drops so often and so fast.
@@Christway1234 mine when I feel hungry the blood pressure is low but didn't check sugar that time
@@Christway1234 what are u diagnosed with? i have same symptom y