title: Long-standing insulinoma: two case reports and review of the literature.
abstract: BACKGROUND
  Insulinomas are rare pancreatic endocrine tumors. Most are benign and solitary. However, the nonspecific symptoms and small size of these tumors led to difficulties of diagnosis and localization.
  
  
  METHODS
  We present two Arab patients with pancreatic long-standing insulinoma. Both patients presented episodic hypoglycemic symptoms respectively during 10 and 2 years. Biochemical and morphological workup detected localized pancreatic insulinoma. Open procedure surgery was done for the two patients and insulinomas were successfully removed by enucleation.
  
  
  CONCLUSIONS
  Insulinoma remains a diagnostic challenge to practitioners. Diagnosis of suspected cases is easily confirmed by standard endocrine tests, especially the supervised fasting test. Accurate preoperative localization is essential for more effective and safest surgery.
authors.affiliation: Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco. mtarchouli@gmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Tarchouli
authors.affiliation: Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco. aitali.mounaim@gmail.com.
authors.forename: Abdelmounaim Ait
authors.initials: AA
authors.lastname: Ali
authors.affiliation: Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco. ratbi-ibrahim@live.fr.
authors.forename: Moulay Brahim
authors.initials: MB
authors.lastname: Ratbi
authors.affiliation: Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco. belhamidimohamedsaid@gmail.com.
authors.forename: Mohamed said
authors.initials: Ms
authors.lastname: Belhamidi
authors.affiliation: Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco. essarghini.med@gmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Essarghini
authors.affiliation: Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco. aboulfethelmehdi@gmail.com.
authors.forename: El Mehdi
authors.initials: el M
authors.lastname: Aboulfeth
authors.affiliation: Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco. dr.bouzroud@gmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bouzroud
authors.affiliation: Department of Oncology, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco. sbittiyassir@yahoo.fr.
authors.forename: Yassir
authors.initials: Y
authors.lastname: Sbitti
authors.affiliation: Department of Pathology, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco. oukablimohamed@yahoo.fr.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Oukabli
authors.affiliation: Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco. elfahssi_mohammed@hotmail.com.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Elfahssi
authors.affiliation: Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco. khalid_sair@yahoo.fr.
authors.forename: Khalid
authors.initials: K
authors.lastname: Sair
mesh_terms: D005260:Female; D006801:Humans; D007340:Insulinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed