Multiple endocrine neoplasia type 1
ICD-10 E31.8 · ICD-11 2F7A.0.1

Treatment of Multiple Endocrine Neoplasia Type 1 (MEN1) with Insulinoma

This protocol applies to patients with Multiple Endocrine Neoplasia Type 1 (MEN1) who have a concurrent insulinoma — an insulin-secreting tumour that produces characteristic episodes of hypoglycaemia.

Clinical Scenario

Patients in this setting present with insulinoma in the context of MEN1. The classic presentation of insulinoma includes Whipple's triad: hypoglycaemic symptoms, a plasma glucose concentration lower than 3·1 mmol/L (<55 mg/dL), and resolution of symptoms after glucose administration.

Treatment Approach

The protocol is centred on a surgical intervention to address the insulinoma. The complete operative strategy, decision algorithm, and case-specific considerations are detailed in the full protocol.

The full regimen — including operative approach, sequencing, and decision criteria — is available via the link below.

Treatment Goals

Long-term hypoglycaemia-free outcomes with resolution of hypoglycaemic symptoms.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/S2213-8587(25)00119-6

Insulinomas typically present with Whipple's triad: hypoglycaemic symptoms, a plasma glucose concen­tration lower than 3·1 mmol/L (<55 mg/dL), and resolution of symptoms after glucose administration.

Surgery is the mainstay of insulinoma treatment and is associated with excellent long-term hypoglycaemia-free outcomes.

If technically feasible, enucleation can be performed for suspected solitary insulinomas with high rates of symptom resolution and minimal risk of pancreatic endocrine and exocrine insufficiency.

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