Case report of a pancreatic insulinoma misdiagnosed as epilepsy

A 55-year-old patient had spent 12 years with unexplained seizures, initially diagnosed as epilepsy and then as a psychiatric disorder. When she was admitted with hypoglycaemia, a fasting test was performed showing blood sugar levels as low as 1 mmol/L with symptoms of neuroglycopenia. Insulinoma wa...

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Veröffentlicht in:	BMJ case reports 2021-05, Vol.14 (5), p.e238238
Hauptverfasser:	Williams, Barbara Anna, Lampart, Simon, Metzger, Jürg, Fischli, Stefan
Format:	Artikel
Sprache:	eng
Schlagworte:	Case Report Case reports Consciousness Diabetes Diagnostic Errors Electroencephalography Emergency medical care Epilepsy Fasting Female Glucose Humans Hypoglycemia Insulin Insulinoma - diagnostic imaging Insulinoma - surgery Laboratories Localization Middle Aged Neuroendocrine tumors Pancreas Pancreatic Neoplasms - diagnostic imaging Patients Peptides Plasma Tomography, X-Ray Computed
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Zusammenfassung:	A 55-year-old patient had spent 12 years with unexplained seizures, initially diagnosed as epilepsy and then as a psychiatric disorder. When she was admitted with hypoglycaemia, a fasting test was performed showing blood sugar levels as low as 1 mmol/L with symptoms of neuroglycopenia. Insulinoma was suspected and an MRI showed a large tumour in the tail region of the pancreas. A Dodecanetetraacetic acid-Tyr3-octreotate (DOTATATE) positron emission tomography CT indicated no malignancy and showed no signs of metastasis. The patient underwent surgery, leaving her asymptomatic.
ISSN:	1757-790X 1757-790X
DOI:	10.1136/bcr-2020-238238