Insulinoma with seizures – a rare presentation of a rare tumour
Abstract
Insulinoma is a rare pancreatic endocrine tumour with an incidence of 4 per million population per year and is typically sporadic, solitary and less than 2 cms in diameter. Fewer than 5% of insulinomas are larger than 3 cms and are more likely to be malignant. Here we report a case of insulinoma in a female patient aged 57 years with a rare presentation of recurrent attacks of seizures, syncope and sweating along with episodes of hypoglycemia since 5 years. CT scan localized the tumour to the head of the pancreas and histopathology proved the diagnosis.
Downloads
References
Grant CS. Surgical aspects of hyperinsulinemic hypoglycemia. Endocrinol Metab Clin North Am. 1999 Sep;28(3):533–54. DOI: https://doi.org/10.1016/S0889-8529(05)70087-6.
Komminoth P, Perren A, Oberg K, Rindi G, Heitz U, Kloppel G. Insulinoma. In:Ronald A, De Lellis, Richardo VL, Phillip UH, eds. WHO Classification of Tumors- Endocrine organs. Lyon:IARC Press;2004. p183-6.
Patel S, Narwaria M, Parekh D, Shah V. Insulinoma : Case report and review of diagnostic and treatment modalities. J Assoc Physicians India. 2013;61:423-6.
Fajans SS, Vinik AI. Insulin-producing islet cell tumors. Endocrinol Metab Clin North Am. 1989 Mar;18(1):45-74.
Zografos GN ,Stathopoulou A, Mitropapas G, Karoubalis J, Kontogeorgos G, Kaltsas G, et al. Preoperative imaging and localization of small sized insulinoma with EUS-guided fine needle tattoing:a case report. Hormones. 2005;4(2):111-6.
Roith DL. Tumor induced hypoglycemia. N Engl J Med. 1999 Sep;341(10):757-8.DOI: https://doi.org/10.1056/NEJM199909023411011.
Gouya H, Vignaux O, Augui J, Dousset B, Palazzo L, Louvel A, et al .CT, endoscopic sonography, and a combined protocol for preoperative evaluation of pancreatic insulinomas. AJR Am J Roentgenol. 2003 Oct;181(4):987-92. DOI: https://doi.org/10.2214/ajr.181.4.1810987.
Filipi CJ, Higgins GA. Diagnosis and management of insulinoma. Am J Surg. 1973 Feb;125(2):231-9.
Williams AJ, Coates PJ, Lowe DG, McLean C, Gale EA. Immunohistochemical investigation of insulinomas for islet amyloid polypeptide and insulin : evidence for differential synthesis and storage. Histopathology. 1992 Sep;21(3):215-23. DOI: https://doi.org/10.1111/j.1365-2559.1992.tb00379.x.
Druce MR, Muthuppalaniappan VM, O’Leary B, Chew SL, Drake WM, Monson JP, et al. Diagnosis and localization of insulinoma:the value of modern magnetic resonance imaging in conjunction with calcium stimulation catheterization. Eur J Endocrinol. 2010 May;162(5):971-8. DOI: https://doi.org/10.1530/EJE-10-0056.
OAI - Open Archives Initiative
