Insulinoma causing liver metastases 15 years after initial surgery, accompanied by glomerulonephritis

Insulinoma is a rare pancreatic endocrine tumor that is typically sporadic, solitary, and less than 2 cm in diameter. Ninety percent of all insulinomas are benign. Up to 10 percent are malignant and are usually larger in size. We report a case of an unusual, not yet described association of two diseases: a malignant pancreatic insulinoma recurred as a multiple liver metastasis 15 years after the initial complete enucleation of a primary tumor with a histomorphological fairly benign outlook, accompanied by ANCA positive crescentic glomerulonephritis.