Abstract

Insulinoma is a rare neuroendocrine tumor that causes inappropriate release of insulin, resulting in episodes of hypoglycemia. It classically present with neuroglycopenic and autonomic sympathetic symptoms. These symptoms resolve promptly following glucose administration. Demonstration of elevated C-peptide level in the presence of hypoglycemia and absence of plasma sulfonylurea is suggestive of the diagnosis. Pre-operative localization of the tumor is essential. Herein, we present the case of middle-aged man who had a 6-month history of recurrent episodes of irritability and fatigue that resolved after eating. Pancreatic insulinoma was localized by computed tomography scan. The patient underwent successful resection of the tumor, and his symptoms showed complete resolution.

Highlights

  • Insulinoma is an insulin-secreting tumor resulting in hypoglycemia

  • Pancreatic insulinoma was localized by computed tomography scan

  • This rare tumor presents with episodes of neuroglycopenic symptoms that may be preceded with sympathetic symptoms

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Summary

Introduction

Insulinoma is an insulin-secreting tumor resulting in hypoglycemia. it is the most common functional pancreatic tumor, insulinoma is very rare with an annual incidence of four cases per million [1]. We present the case of middle-aged man who had a six-month history of recurrent episodes of irritability and fatigue that resolved after eating He had a road traffic accident that was related to loss of consciousness as a result of hypoglycemia. He had a road traffic accident two months prior to presentation that was related to loss of consciousness as a result of hypoglycemic event His medical history is remarkable for a recently diagnosed hypertension that is well controlled by amlodipine 5 mg daily. Given the aforementioned clinical and laboratory findings, abdominal computed tomography (CT) scan was performed to confirm the diagnosis of insulinoma It demonstrated a single enhancing lesion located at the head of the pancreas measuring 1.5 × 1.0 cm (Figure 1).

Discussion
Disclosures
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