title: Giant malignant insulinoma.
abstract: Insulinomas are the most common pancreatic neuroendocrine tumors. Most insulinomas are benign, small, intrapancreatic solid tumors and only large tumors have a tendency for malignancy. Most patients present with symptoms of hypoglycemia that are relieved with the administration of glucose. We herein present the case of a 75-year-old woman who presented with an acute hypoglycemic episode. Subsequent laboratory and radiological studies established the diagnosis of a 17-cm malignant insulinoma, with local invasion to the left kidney, lymph node metastasis, and hepatic metastases. Patient symptoms, diagnostic and imaging work-up and surgical management of both the primary and the metastatic disease are reviewed.
authors.affiliation: Department of Surgery, University Hospital of Patras, Rion, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karavias
authors.affiliation: Division of Endocrinology and Diabetes, Department of Internal Medicine, University Hospital of Patras, Rion, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Habeos
authors.affiliation: Department of Surgery, University Hospital of Patras, Rion, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Maroulis
authors.affiliation: Department of Radiology, University Hospital of Patras, Rion, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Kalogeropoulou
authors.affiliation: Department of Pathology, University Hospital of Patras, Rion, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Tsamandas
authors.affiliation: Department of Surgery, University Hospital of Patras, Rion, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Chaveles
authors.affiliation: Department of Surgery, University Hospital of Patras, Rion, Greece.
authors.forename: Dionissios
authors.initials: D
authors.lastname: Karavias
keywords: Giant tumor; Insulinoma; PNET