title: Pancreatic insulinoma co-existing with gastric GIST in the absence of neurofibromatosis-1.
abstract: BACKGROUND
  Gastrointestinal stromal tumours (GIST) frequently occur in patients with neurofibromatosis type 1 (NF-1). It has been reported that GIST may co-exist with pancreatic endocrine tumors but this has only been in association with NF-1.
  
  
  METHODS
  A 76 year old woman presented with a 12 month history of hypoglycaemia symptoms. Abdominal CT scan demonstrated a 13 mm insulinoma localized in the tail of her pancreas. She was commenced on diazoxide and later underwent surgery for enucleation of insulinoma when a small (< 1 cm) incidental tumour was discovered on her stomach wall which was identified as GIST.
  
  
  CONCLUSIONS
  This is the first case report of a pancreatic insulinoma co-existing with a GIST in a patient without NF-1. In addition, we make the first report of rapidly growing cystic GIST recurrence following resection of a primary GIST tumour.
authors.affiliation: University of Birmingham and UHB Foundation NHS Trust, Birmingham, UK. e.b.alabraba@bham.ac.uk
authors.forename: Edward
authors.initials: E
authors.lastname: Alabraba
authors.forename: Simon
authors.initials: S
authors.lastname: Bramhall
authors.forename: Brendan
authors.initials: B
authors.lastname: O'Sullivan
authors.forename: Brinder
authors.initials: B
authors.lastname: Mahon
authors.forename: Philippe
authors.initials: P
authors.lastname: Taniere
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis; D007340:Insulinoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D009456:Neurofibromatosis 1; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D013274:Stomach Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed