This approach is reasonable because carcinoids and their metastases grow slowly. If metastases cannot be removed, palliative treatment with octreotide, a long-acting somatostatin analog, may be considered. Octreotide has been reported to relieve symptoms and slow the growth of carcinoids.
This tumor is composed of Vegas Slots Online cells and almost always originates from the beta cells of the pancreatic islets. There are reports of insulinomas arising from enterochromaffin cells in the intestine. Insulinoma in the pancreas is usually benign, solid, solitary. In children, insulinoma is sometimes accompanied by beta-cell hyperplasia or nesidioblastosis. Insulinoma is often a component of type I MEN (see Chapter 45, section II.A).
Determine the level of insulin in plasma by RIA. The most informative determination of insulin during an attack of giglycemia. The diagnosis is not in doubt if, against the background of hypoglycemia (at a blood glucose concentration of 72 pmol / l. Usually, the insulin level exceeds 144 pmol / l.
Play With $10 Free - removal of the tumor. If the insulinoma is located in the tail of the pancreas, the tail is resected. If the insulinoma is located in the body or head of the gland, it is excised. When the tumor is malignant, gives multiple metastases and cannot be completely removed, resort to drug treatment with diazoxide or octreotide. These drugs suppress insulin secretion and reduce the severity of hypoglycemia. Glucocorticoids are also used (these drugs have a contra-insular effect).
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Clinical picture. The most characteristic signs of glucagonoma are skin lesions, mild diabetes mellitus, anemia, and weight loss. Glossitis, thinning hair, nail dystrophy, and diarrhea are less common.
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Necrolytic erythema migrans is most often localized on the face, lower abdomen and in places subject to friction - in the groin or on the thighs. Sometimes erythema is complicated by an attached infection.
Diabetes mellitus is caused by the contra-insular action of glucagon. It is sometimes asymptomatic and is only detected by an oral glucose tolerance test. Characteristic features of diabetes mellitus with glucagonoma: ketonemia and diabetic ketoacidosis rarely occur, there are no microangiopathic complications. In most patients with diabetes mellitus amenable to diet. About 25% of patients require insulin.
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