Insulinoma

I-insulinoma iyisigaxa samanyikwe esikhiqiza insulini eningi kakhulu.

Ama-pancreas isitho esiswini. Ama-pancreas enza ama-enzyme namahomoni amaningana, kufaka phakathi i-hormone insulin. Umsebenzi we-insulin ukunciphisa izinga likashukela (i-glucose) egazini ngokusiza ushukela ukuthi ungene kumaseli.

Isikhathi esiningi lapho ushukela wegazi lakho wehla, amanyikwe ayayeka ukwenza i-insulin ukuze aqiniseke ukuthi ushukela wegazi lakho uhlala ebangeni elijwayelekile. Izimila zamanyikwe ezikhiqiza i-insulin eningi kakhulu zibizwa ngama-insulinoma. Ama-insulinulin aqhubeka enza i-insulin, futhi angenza izinga likashukela egazini libe phansi kakhulu (i-hypoglycemia).

Izinga eliphezulu le-insulin egazini lidala izinga eliphansi likashukela egazini (i-hypoglycemia). I-Hypoglycemia ingaba mnene, iholele ezimpawu ezifana nokukhathazeka nendlala. Noma kungaba nzima, okuholele ekuqulekeni, ekuqulekeni, nasekufeni.

Ama-insulinoma izicubu ezingavamile kakhulu. Imvamisa zenzeka njengezicubu ezingashadile, ezincane. Kepha kungabuye kube nezicubu ezincane eziningana.

Iningi lama-insulinoma yizimila ezingenawo umdlavuza (ezinobungozi). Abantu abanezinkinga ezithile zofuzo, ezinjenge-endocrine neoplasia yohlobo I, basengozini enkulu ye-insulinomas.

Izimpawu zivame kakhulu uma uzila ukudla noma weqa noma ulibazisa ukudla. Izimpawu zingafaka:

• Ukukhathazeka, ukuguquka kokuziphatha, noma ukudideka
• Umbono osibekele
• Ukulahlekelwa ukwazi noma ikhoma
• Ukudlikizela noma ukuvevezela
• Isiyezi noma ikhanda
• Indlala phakathi kokudla; ukuzuza kwesisindo kuvamile
• Ukushaya kwenhliziyo okusheshayo noma ukushaya kwenhliziyo
• Ukujuluka

Ngemuva kokuzila ukudla, igazi lakho lingahlolwa:

• Izinga le-C-peptide yegazi
• Izinga le-glucose yegazi
• Izinga le-insulin yegazi
• Izidakamizwa ezenza amanyikwe akhiphe i-insulin
• Impendulo yomzimba wakho ekudutshulweni kwe-glucagon
  

Ukuhlolwa kwesisu kwe-CT, i-MRI, noma i-PET kungenziwa ukubheka isimila kumanyikwe. Uma isimila singabonakali kwizikena, kungenziwa okunye kokuhlolwa okulandelayo:

• I-endoscopic ultrasound (isivivinyo esisebenzisa ububanzi obuguquguqukayo namagagasi omsindo ukubuka izitho zokugaya ukudla)
• Ukuskena kwe-Octreotide (ukuhlolwa okukhethekile okuhlola amaseli akhiqiza ama-hormone athile emzimbeni)
• I-Pancreatic arteriography (isivivinyo esisebenzisa udayi okhethekile ukubuka imithambo yegazi emanyikwe)
• Isampula ye-pancreatic venous ye-insulin (ukuhlolwa okusiza ukuthola indawo eseduze nesimila ngaphakathi kwamanyikwe)

Ukuhlinzwa yindlela yokwelashwa ejwayelekile ye-insulinoma. Uma kukhona isimila esisodwa, sizosuswa. Uma kunezimila eziningi, ingxenye yamanyikwe kuzodingeka isuswe. Okungenani u-15% wamanyikwe kufanele ashiywe ukukhiqiza amazinga ajwayelekile ama-enzyme wokugaya ukudla.

Ezimweni ezingavamile, wonke amanyikwe asuswa uma kukhona ama-insulin amaningi noma aqhubeka nokubuya. Ukususa wonke amanyikwe kuholela kusifo sikashukela ngoba ayisekho i-insulin ekhiqizwa. Ama-insulini shots (imijovo) ayadingeka.

Uma kungatholakali isimila ngesikhathi sokuhlinzwa, noma uma ungakwazi ukuhlinzwa, ungathola umuthi i-diazoxide yokwehlisa ukukhiqizwa kwe-insulin nokuvikela i-hypoglycemia. Iphilisi lamanzi (isisu) linikezwa ngalo muthi ukuvimbela umzimba ekugcineni uketshezi. I-Octreotide ngomunye umuthi osetshenziselwa ukunciphisa ukukhishwa kwe-insulin kwabanye abantu.

Ezimweni eziningi, isimila asinomdlavuza (sinobuthi), futhi ukuhlinzwa kungaselapha lesi sifo. Kodwa ukusabela okunzima kwe-hypoglycemic noma ukusabalala kwesimila somdlavuza kwezinye izitho kungasongela impilo.

Izinkinga zingafaka:

• Ukusabela okukhulu kwe-hypoglycemic
• Ukusabalala kwesimila somdlavuza (i-metastasis)
• Isifo sikashukela uma kususwe wonke amanyikwe (akuvamile), noma ukudla kungamuncwa uma amanyikwe amaningi esusiwe
• Ukuvuvukala nokuvuvukala kwamanyikwe

Shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma uba nezimpawu ze-insulinoma. Ukuquleka nokulahlekelwa ukwazi kuyisimo esiphuthumayo. Shayela ku-911 noma inombolo ephuthumayo yendawo ngokushesha.

Insulinoma; Islet cell adenoma, isimila se-Pancreatic neuroendocrine; Hypoglycemia - insulini

• Izindlala ze-Endocrine
• Ukukhishwa kokudla kanye ne-insulin

UAsban A, uPatel AJ, uReddy S, uWang T, uBalentine CJ, uKen H. Umdlavuza wohlelo lwe-endocrine. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 68.

Iwebhusayithi ye-National Comprehensive Cancer Network. Imikhombandlela ye-NCCN yokwenza imitholampilo ku-oncology (imihlahlandlela ye-NCCN): Neuroendocrine kanye nezicubu ze-adrenal. Inguqulo 2.2020. www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. Kubuyekezwe ngoJulayi 24, 2020. Kufinyelelwe ngoNovemba 11, 2020.

IStrosberg JR, i-Al-Toubah T.Izicubu ze-Neuroendocrine. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 34.