engleski

Insulinoma as a rare cause of hypoglycaemia - a case report

Introduction Insulinoma is a rare neuroendocrine tumour originating from pancreatic β-⁠cells. Hypoglycemia is seen in patients with diabetes treated with insulin and sulfonylureas, alcohol abuse, and starvation. Severe spontaneous hypoglycemia is uncommon and can be caused by this rare tumour. Case presentation We are presenting a case of a 28-year-old female patient who presents with dizziness, weakness, and frequent loss of awareness for three months. The neurological exam was normal, but low glucose levels (1.6-⁠1.7 mmol/⁠L) detected. Diagnostic procedures The neurological exam was normal, but low glucose levels (1.6-1.7 mmol/L) were detected. In the hospital, the 72h-fasting test stopped at 48h with a glucose level of 1.8mmol/L and insulin of 9.8 mU/I, indicating inadequate physiological suppression of the endogenous insulin. Based on hypoglycemia and endogenous hyperinsulinemia, insulinoma was suspected. Endoscopic ultrasound showed normal echostructure of the pancreas. MRI scan revealed a round-shaped focal lesion measuring 1.5x1 cm at the distal part of the pancreatic head, within the parenchyma that was inconclusive for the tumour or physiological feature of the pancreas. Conclusion Early diagnosis and precise localization of insulinoma are crucial to minimizing the risk of unsuccessful surgical resection and to prevent long-⁠term complications associated with hypoglycemia. This case highlights the importance of considering insulinoma as a potential cause of hypoglycemia and utilizing appropriate diagnostic tools for tumour localization.

hypoglycaemia ; insulinoma ; neuroendocrine tumour

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