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Related Concept Videos

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The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
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Related Experiment Video

Updated: Dec 8, 2025

Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
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Extrapancreatic insulinoma.

Robin Garg1, Saba Memon1, Virendra Patil1

  • 1Department of Endocrinology, Seth GS Medical College, Mumbai, Maharashtra, India.

World Journal of Nuclear Medicine
|September 17, 2020
PubMed
Summary

This study reports a rare case of ectopic insulinoma in the jejunum, diagnosed using 68Ga-Exendin-4 PET/CT. Surgical removal of the jejunal neuroendocrine tumor (NET) successfully treated the patient's hypoglycemia.

Keywords:
68Ga-DOTATATE positron emission tomography/computerized tomography68Ga-Exendin-4 positron emission tomography/computerized tomographyectopic jejunal insulinoma

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Area of Science:

  • Endocrinology
  • Oncology
  • Nuclear Medicine

Background:

  • Recurrent hypoglycemia can indicate endogenous hyperinsulinemic hypoglycemia, often caused by pancreatic insulinomas.
  • Diagnostic imaging like CT and Ga-DOTATATE PET/CT may fail to detect rare ectopic insulinoma locations.

Observation:

  • A 38-year-old female experienced persistent hypoglycemia, with imaging revealing a jejunal lesion suggestive of a neuroendocrine tumor (NET) but not a pancreatic insulinoma.
  • Ga-Exendin-4 PET/CT demonstrated specific uptake in the jejunum, confirming an ectopic insulinoma.

Findings:

  • The jejunal NET was surgically excised, leading to complete resolution of hypoglycemia.
  • This case confirms ectopic insulinoma in the jejunum as a rare but treatable cause of hyperinsulinemic hypoglycemia.

Implications:

  • Ga-Exendin-4 PET/CT is a valuable tool for localizing ectopic insulinomas when conventional imaging is inconclusive.
  • Awareness of rare ectopic locations is crucial for accurate diagnosis and management of hyperinsulinemic hypoglycemia.