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Lessons to be learned: a case study approach insulinoma presenting as a change in personality
1Department of Surgery, East Surrey Hospital, Redhill, Surrey RH1 5RH, England. svig@doctors.org.uk
Summary
This case study highlights a patient with altered behavior due to hypoglycemia, diagnosed as insulinoma. Surgical removal of the pancreatic tumor resolved symptoms, confirming insulinoma as the cause.
Area of Science:
- Endocrinology
- Surgical Oncology
Background:
- Insulinoma, a rare pancreatic neuroendocrine tumor, causes hypoglycemia due to excessive insulin secretion.
- Clinical presentation can be varied, including behavioral changes and neurological symptoms.
Observation:
- A 43-year-old male presented with episodic altered behavior linked to hypoglycemia.
- Elevated serum insulin and C-peptide levels during hypoglycemic episodes suggested endogenous hyperinsulinism.
Findings:
- Imaging (CT, endoscopic ultrasound) identified a pancreatic head lesion.
- Laparoscopic enucleation successfully removed a 2.6 cm benign insulinoma.
- Histopathology confirmed the diagnosis of insulinoma.
Implications:
- This case underscores the importance of considering insulinoma in patients with unexplained hypoglycemia and behavioral changes.
- Prompt diagnosis and surgical management are crucial for favorable outcomes.
- Understanding the diverse clinical manifestations aids in differential diagnosis.