Insulinoma

Insulinoma cuta ce mai ciwan ciki wanda ke samar da insulin da yawa.

Pancreas wani yanki ne a cikin ciki. Pancreas yana yin enzymes da homon da yawa, gami da insulin. Aikin insulin shine rage matakin suga (glucose) a cikin jini ta hanyar taimakawa sukari ya koma cikin sel.

Mafi yawan lokuta idan matakin sukarin jininku ya ragu, pancreas takan daina yin insulin don tabbatar da cewa jinin ku ya zauna a cikin zangon da ya saba. Tumor na pancreas da ke samar da insulin da yawa ana kiran su insulinomas. Insulinomas suna ci gaba da yin insulin, kuma zasu iya sanya matakin sikarin jininka yayi kasa (hypoglycemia).

Matsayin insulin na jini yana haifar da ƙarancin sukarin jini (hypoglycemia). Hypoglycemia na iya zama mai sauƙi, yana haifar da bayyanar cututtuka irin su damuwa da yunwa. Ko kuma yana iya zama mai tsanani, wanda ke haifar da kamuwa da cuta, suma, har ma da mutuwa.

Insulinomas ƙananan ciwace-ciwace. Yawancin lokaci suna faruwa ne kamar ƙananan ƙwayoyi. Amma kuma za'a iya samun ƙananan ƙwayoyi da yawa.

Yawancin insulinomas sune cututtukan daji (marasa lafiya). Mutanen da ke da wasu cututtukan kwayar halitta, irin su nau'in endoprin neoplasia na I, suna cikin haɗarin haɗarin insulinomas.

Alamomin cutar sun fi yawa yayin da kake azumi ko tsallake ko jinkirta abinci. Kwayar cutar na iya haɗawa da:

• Damuwa, canjin hali, ko rikicewa
• Haske mai duhu
• Rashin sani ko suma
• Varfafawa ko rawar jiki
• Dizziness ko ciwon kai
• Yunwa tsakanin abinci; karuwar nauyi na kowa ne
• Saurin bugun zuciya ko bugun zuciya
• Gumi

Bayan azumi, za'a iya gwada jininka don:

• Matakan C-peptide na jini
• Matakan glucose na jini
• Matsayin insulin na jini
• Magungunan da ke haifar da pancreas su saki insulin
• Amsar jikinka zuwa harbin glucagon
  

CT, MRI, ko PET scan na ciki za a iya yi don neman ƙari a cikin pancreas. Idan ba a ga ƙari a cikin sikanin ba, ana iya yin ɗayan gwaje-gwaje masu zuwa:

• Endoscopic duban dan tayi (gwajin da ke amfani da sassauƙa da igiyar ruwa don duba gabobin narkewa)
• Octreotide scan (gwaji na musamman da ke bincika takamaiman kwayoyin samar da hormone a cikin jiki)
• Pancreatic arteriography (gwajin da ke amfani da fenti na musamman don duba jijiyoyin cikin pancreas)
• Samfurin cututtukan Pancreatic na insulin (gwajin da ke taimakawa gano kusan wurin da kumburin yake a cikin pancreas)

Yin aikin tiyata shine magani don insulinoma. Idan akwai ƙari guda ɗaya, za'a cire shi. Idan akwai ciwowi da yawa, ana bukatar cire wani bangare na pancreas din. Dole a bar aƙalla 15% na pancreas don samar da matakan yau da kullun na enzymes don narkewa.

A cikin al'amuran da ba safai ba, ana cire duka pancreas idan akwai insulinomas da yawa ko kuma suna ci gaba da dawowa. Cire dukan abincikin ya haifar da ciwon suga saboda babu sauran wani insulin da ake samarwa. Hakanan ana buƙatar ɗaukar insulin (injections).

Idan ba a sami kumburi a lokacin tiyata ba, ko kuma idan ba za ku iya yin tiyata ba, kuna iya samun maganin diazoxide don rage samar da insulin da hana hypoglycemia. Ana ba da kwayar ruwa (diuretic) tare da wannan maganin don hana jiki riƙe ruwa. Octreotide wani magani ne wanda ake amfani dashi don rage fitowar insulin a cikin wasu mutane.

A mafi yawan lokuta, ciwace-ciwacen ba na cutar kansa bane (mara kyau), kuma tiyata na iya warkar da cutar. Amma mummunan aiki na hypoglycemic ko yaduwar cutar kansa zuwa wasu gabobin na iya zama barazanar rai.

Matsaloli na iya haɗawa da:

• Raunin hypoglycemic mai tsanani
• Yaduwar cutar kansa (metastasis)
• Ciwon suga idan aka cire duka ƙwayar cuta (ba kasafai ake samu ba), ko abinci baya sha yayin da aka cire yawan pancreas din.
• Kumburi da kumburin ciki

Kira mai ba da sabis na kiwon lafiya idan kun ci gaba da alamun insulinoma. Karɓar jiki da rashin hankali abu ne na gaggawa. Kira 911 ko lambar gaggawa na gaggawa kai tsaye.

Insulinoma; Isen cell, tsinkayyar ciwon daji na neuroendocrine; Hypoglycemia - insulinoma

• Endocrine gland
• Abinci da fitowar insulin

Asban A, Patel AJ, Reddy S, Wang T, Balentine CJ, Chen H. Ciwon daji na tsarin endocrine. A cikin: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff na Clinical Oncology. Na 6 ed. Philadelphia, PA: Elsevier; 2020: babi na 68.

Yanar gizo Yanar Gizon Cutar Kanjamau ta Kasa. NCCN jagororin aikin likita a cikin ilimin ilimin halittar jiki (jagororin NCCN): Neuroendocrine da adrenal marurai. Sigar 2.2020. www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. An sabunta Yuli 24, 2020. An shiga Nuwamba 11, 2020.

Strosberg JR, Al-Toubah T. Ciwan daji na Neuroendocrine. A cikin: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger da Cututtukan Cutar hanta da na Fordtran. 11th ed. Philadelphia, PA: Elsevier; 2021: babi na 34.