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Related Experiment Videos

Insulinoma: diagnosis and localization procedures.

Monica C Rodriguez1, Ganesh Nair

  • 1Department of Medicine, Division of Endocrinology, UAMS and the Central Arkansas Veterans Healthcare System, USA.

The Journal of the Arkansas Medical Society
|March 28, 2006
PubMed
Summary

A rare pancreatic tumor, insulinoma, caused severe hypoglycemia in a young woman. Surgical removal of the insulinoma successfully resolved her symptoms, highlighting the importance of accurate tumor localization.

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Area of Science:

  • Endocrinology
  • Oncology
  • Radiology

Background:

  • Insulinoma, a rare neuroendocrine tumor, arises from pancreatic beta cells and is the most common cause of endogenous hyperinsulinemic hypoglycemia.
  • Diagnosis involves biochemical testing during a documented hypoglycemic episode and imaging for tumor localization.
  • Preoperative localization is crucial for successful surgical resection and management.

Observation:

  • A 26-year-old woman presented with symptomatic hypoglycemia (plasma glucose 30 mg/dL) during a 72-hour fast.
  • Biochemical tests revealed elevated insulin (11 µIU/mL), proinsulin (16.8 pmol/L), and C-peptide (2.3 ng/mL), consistent with endogenous hyperinsulinism.
  • Magnetic Resonance Imaging (MRI) identified a 12mm pancreatic head mass.

Findings:

  • The pancreatic mass was surgically resected and confirmed as an insulinoma via pathology.

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  • Postoperatively, the patient remained asymptomatic with normalized glucose levels during fasting.
  • The case underscores the diagnostic utility of MRI in identifying insulinoma.

    • Implications:

    • This case highlights the successful management of insulinoma through prompt diagnosis and surgical intervention.
    • It emphasizes the critical role of advanced imaging modalities like MRI in the preoperative localization of pancreatic neuroendocrine tumors.
    • Effective localization and resection lead to complete resolution of hypoglycemia and improved patient outcomes.