Insulinoma in a thin Lean Indian male

Abstract

Insulinoma is a tumor that secretes insulin, leading to hypoglycemia as a result of excessive insulin release. The diagnosis of insulinoma is based on the presence of Whipple’s triad, which includes the following criteria: symptoms of hypoglycemia such as tremor, sweating, irritability, uneasiness, and weakness; a plasma glucose concentration of less than 55 mg/dL (3.0 mmol/L); and resolution of symptoms upon administration of glucose. A 30-year-old male presented with recurrent episodes of palpitations, sweating, dizziness, and vision difficulty, primarily occurring in a fasting state and relieved by food ingestion. Investigations revealed hypoglycemia during an episode, along with endogenous hyperinsulinism. Imaging studies showed a hyperenhancing lesion in the pancreatic body, which was confirmed as a neuroendocrine tumor on histology and immunohistochemistry. The patient underwent enucleation of the lesion, resulting in the normalization of plasma glucose levels postoperatively.