[The neuroglycopenic syndrome due to insulinoma. A clinical case report]

The authors report a case of a woman affected by pancreatic insulinoma who had been suffering from recurrent and misdiagnosed hypoglycemic attacks since 3 years. The total loss of warning neurogenic symptoms replaced by sudden onset of neuroglycopenic symptoms had delayed the proper and early diagnosis because of repeated and useless cardiovascular and neurological investigations. Moreover, it is stressed how difficult is to reveal such neoplasia that, despite the severe symptoms, are usually small in size and often undetectable even with TC scan. Therefore, when clinical pattern is strongly suggestive for insulinoma the use of invasive angiography or other techniques is mandatory and often conclusive. Actually clinical data have the priority in whole diagnostic pathway.