Insulinoma: case report and review of diagnostic and treatment modalities

Insulinomas account for 60% of islet cell tumours (ICT) and are typically hypervascular, solitary small tumours, 90% of which measure less than 2 cm and 30% measuring less than 1 cm in diameter. Approximately 10% are multiple, 10% are malignant and 4-7% are associated with MEN I; these tumours are usually multiple and can be malignant in up to 25%. The tumour is characterized by endogenous hypersecretion of insulin and the subsequent development of symptoms of neuroglycopenia and symptoms resulting from the catecholaminergic response, which may not always be present. Early localisation of the disease is essential to prevent lethal hypoglycaemia. We report a case of insulinoma in a 27 year old male and review of diagnostic modalities to localise the tumour and open v/s laparoscopic enucleation of the tumour.