Insulinoma

Case contributed by Dr Bahman Rasuli

Presentation

Episodes of seizures associated with severe hypoglycemia.

Patient Data

Age: 35 years
Gender: Female
MRI

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.

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Case information

rID: 69381
Published: 9th Jul 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Jame Jam Imaging Center

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