Presentation
Episodes of seizures associated with severe hypoglycemia.
Patient Data
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Axial T2 weighted images demonstrate an ovoid solid mass lesion in the body of the pancreas with high signal intensity and well-defined contours inferior to the major pancreatic duct.
Axial T1 weighted in-phase and out-of-phase images demonstrate a signal drop within this lesion on the opposed-phased images.
Axial gadolinium contrast T1 weighted images demonstrate vivid enhancement and rapid wash out.
Case Discussion
Recurrent seizure and hypoglycemia in a young female since one month.
Laboratory data:
- fasting plasma glucose level: 28 mg/dl ( Fasting normal range: 90-150 mg/dl)
- pro-insulin level: 21 pmol/l (NL< 5)
- C- peptide: 5 nmol/l (NL<0.2 )
- negative sulfonylurea test
The neurological syndromes were alleviated by oral carbohydrates
Regarding the imaging, laboratory and clinical findings (Whipple triad), neuroendocrine tumors of the pancreas (Insulinoma) is the final diagnosis.