Presentation
Episodes of seizures associated with severe hypoglycemia.
Patient Data
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.