Enucleation of Pancreatic Proinsulinoma: Case Report

Abstract

Functional islet beta-cell tumours represent 1%-2% of all pancreatic neoplasms. Diagnosing this type of tumour is often challenging because they present unspecific clinical features overlapping more common syndromes. Diagnosis involves expensive testing, so, establishing Whipple´s triad and excluding causes of exogenous hyperinsulinemia is crucial before initiating investigation. During the investigation, identification of hypoglycaemia associated with inappropriately high levels of insulin and C-peptide should prompt the exclusion of rare causes of hypoglycaemia, including pancreatic islet-cells disease. Surgical resection of pancreatic islet-cells adenomais the primary treatment modality so, accurate localization of the tumour is important, as it enables more conservative intervention. In this paper, we describe a rare case of hypoglycaemia associated with endogenous hyperinsulinism and review important aspects of the diagnosis and treatment.