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Treatment of Insulinoma
Source: Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: May 9, 2025 · Captured 2026-09-09.
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Curative surgical excision, by open laparotomy or laparoscopy, is the treatment of choice when possible. The open surgical approach is used if the tumor is suspected to be malignant because en bloc lymphadenectomy is performed for malignant tumors without distant metastases. Intraoperative ultrasonography aids the localization of tumor extent and the relationship to other anatomical structures.[1]
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Treatment options:
Single, small lesion in the head or tail of the pancreas:[1-4]
Enucleation, if feasible.
Large lesion in the head of the pancreas that is not amenable to enucleation:[1-4]
Large lesion in the head of the pancreas that is not amenable to enucleation:[1-4]
Pancreaticoduodenectomy.
Single, large lesion in the body/tail:[1-4]
Distal pancreatectomy.
Multiple lesions (may occur in 10% of patients, often in association with multiple endocrine neoplasia syndrome type 1):[1-4]
Multiple lesions (may occur in 10% of patients, often in association with multiple endocrine neoplasia syndrome type 1):[1-4]
Distal pancreatectomy with enucleation of tumors in the head of the pancreas.
Metastatic lesions in lymph nodes or distant sites:[5-12]
Resect when possible.
Metastatic lesions in lymph nodes or distant sites:[5-12]
Consider radiofrequency or cryosurgical ablation, if not resectable.
Unresectable:[13-22]
Combination chemotherapy.
Unresectable:[13-22]
Pharmacological palliation: diazoxide 300 to 500 mg/day.
Unresectable:[13-22]
Somatostatin analogue therapy.
Patients with hepatic-dominant disease and substantial symptoms caused by tumor bulk or hormone-release syndromes may benefit from procedures that reduce hepatic arterial blood flow to metastases (hepatic arterial occlusion with embolization or with chemoembolization).[6,8-12] Such treatment may also be combined with systemic chemotherapy in selected patients.
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Preserved source evidence · Not medical advice