title: Endoscopic ultrasound localization of a solitary insulinoma of pancreatic tail misdiagnosed as epilepsy: case report.
abstract: A 17-year-old female patient with features of epilepsy was treated with valproic acid. Two years later, hypoglycemia and hyperinsulinemia appeared. Transabdominal ultrasonography, spiral computed tomography, and indium-111 Octreoscan were performed without positive results. Endoscopic ultrasonography identified an oval tumor in the pancreatic tail with a color Doppler hypervascular pattern. Surgical enucleation decreased levels of insulin and C-peptide within 20 min, and the patient became free of symptoms and medications.
authors.affiliation: Gastroenterology Unit, Ospedali Riuniti of Foggia, Viale L. Pinto, 71100 Foggia, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Muscatiello
authors.forename: R
authors.initials: R
authors.lastname: Cuomo
authors.forename: M
authors.initials: M
authors.lastname: Gentile
authors.forename: V
authors.initials: V
authors.lastname: De Francesco
authors.forename: V
authors.initials: V
authors.lastname: Stoppino
authors.forename: A
authors.initials: A
authors.lastname: Contillo
authors.forename: A
authors.initials: A
authors.lastname: Salcuni
authors.forename: C
authors.initials: C
authors.lastname: Natale
authors.forename: C
authors.initials: C
authors.lastname: Panella
authors.forename: E
authors.initials: E
authors.lastname: Ierardi
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D002096:C-Peptide / Q000097:blood; D003951:Diagnostic Errors; D019160:Endosonography; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007340:Insulinoma / Q000000981:diagnostic imaging* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D002096:C-Peptide; D007328:Insulin; D014635:Valproic Acid