Insulinoma: Metastatic Recurrence 38 Years Following Initial Diagnosis in Pregnancy

A case of recurrent insulinoma spanning 4 decades is described. Following a delayed diagnosis, hyperinsulinemic hypoglycemia was confirmed in a 24-year-old woman during early pregnancy. Initial surgery, culminating in subtotal pancreatectomy, was noncurative. A 1-cm insulinoma was subsequently resec...

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Veröffentlicht in:JCEM case reports 2024, Vol.2 (2), p.luad168-luad168
Hauptverfasser: Preston, Christopher A, Sachithanandan, Nirupa, Sim, Ie-Wen, van Heerden, Jon, Farrell, Stephen
Format: Report
Sprache:eng
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Zusammenfassung:A case of recurrent insulinoma spanning 4 decades is described. Following a delayed diagnosis, hyperinsulinemic hypoglycemia was confirmed in a 24-year-old woman during early pregnancy. Initial surgery, culminating in subtotal pancreatectomy, was noncurative. A 1-cm insulinoma was subsequently resected from the head of the pancreas postpartum, with postoperative resolution of hypoglycemia. However, 32 years later, the patient experienced a recurrence of hypoglycemic symptoms. Eventually, a subcentimeter extrapancreatic lesion was identified anterior to the pancreatic head on gallium-68 DOTA-Exendin-4 positron emission tomography/computed tomography. In 2022, a third operation was performed, with excision of a 4 × 3 mm tumor adjacent to the pancreatic head, and histology confirming insulinoma. She was again cured of symptoms.
ISSN:2755-1520
DOI:10.1210/jcemcr/luad168