Diagnosis of insulinoma in a patient with hypoglycemia without obvious hyperinsulinemia.
BACKGROUND
A 41-year-old Maltese woman with a 12-month history of severe, morning episodes of confusion, blurred vision and sweating was referred to a specialist center for evaluation of fasting hypoglycemia. She was not taking medication and did not report any prior personal or familial history of endocrinopathy or other relevant pathology.


METHODS
Measurement of plasma glucose, insulin, C-peptide, and beta-hydroxybutyrate concentrations during a prolonged supervised fast; sulfonylurea screen; CT, MRI scan and endoscopic ultrasonography of the pancreas; calcium stimulation test; surgical exploration and intra-operative ultrasonography of the pancreas.


METHODS
Insulin-secreting lesion (insulinoma) in the tail of the pancreas.


RESULTS
The tumor was resected with cure of symptoms.
Endocrinology Department of Garcia de Orta Hospital, Almada, Portugal.
Catarina
C
Coelho
Maralyn R
MR
Druce
Ashley B
AB
Grossman
D000328:Adult; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000175:diagnosis / Q000473:pathology*; D007003:Hypoglycemia / Q000150:complications* / Q000473:pathology; D007340:Insulinoma / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography