Malignant Insulinoma: Diagnostic Difficulties and Treatment Strategies in a Case of Persistent Hypoglycemia
Year: 2024
Type: article
Study design: Case Report
Abstract: Hypoglycemia in non-diabetic individuals is a rare but critical condition that often signals an underlying pathology. Insulinoma, a rare neuroendocrine tumor of the pancreas, is a key differential diagnosis. As the most common functional pancreatic neuroendocrine tumors, insulinomas originate from pancreatic islet cells and are predominantly benign. However, malignant cases, although rare, represent a significant diagnostic challenge. Here, we report a 67-year-old female with recurrent hypoglycemic episodes presenting as diaphoresis and palpitations, alleviated by glucose intake. Initial tests revealed critically low blood sugar levels and elevated fasting insulin and C-peptide. Despite a normal abdominal CT, a PET-CT scan identified an exophytic pancreatic lesion with metastases to retroperitoneal lymph nodes, and malignancy was confirmed by histopathological examination. This case highlights the necessity of considering insulinoma in the differential diagnosis of unexplained hypoglycemia. Accurate and timely diagnosis, along with appropriate imaging and management, is crucial for effective treatment and improved patient outcomes.
Source: Cureus
DOI: 10.7759/cureus.74700
Authors: Shubh Mehta, Ahan Banker, Jay V Shah
Institution: B.J. Medical College
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4404869505
