Giant insulinoma in a 15-year-old man: A case report.
BACKGROUND
Giant insulinomas are extremely rare pancreatic neuroendocrine tumor.


METHODS
A 15-year-old man presenting with acute onset of lightheadedness was found to have serum glucose of 1.5mmol/L. The blood collected from the hypoglycemic episode showed an inappropriately high insulin and C-peptide level. Abdominal computerized tomography showed a 12.5cm well-defined, lobulated hypervascular mass at pancreatic tail, without any evidence of metastasis. En bloc resection with distal pancreatectomy, and splenectomy was successfully performed. The pathological examination confirmed insulinoma, with benign characteristics. Follow-up after the procedure revealed neither hypoglycemic, nor hyperglycemia.


CONCLUSIONS
We report the youngest case of a giant insulinoma. Despite the size of the tumor, the pathological report confirmed the benign characteristics. However, long-term follow-up is still essential to detect recurrence in the future.
Department of Medicine, Anandamahidol Hospital, Lopburi 15000, Thailand. Electronic address: vvasin@gmail.com.
Vasin
V
Vasikasin
Department of Surgery, Anandamahidol Hospital, Lopburi 15000, Thailand.
Jirawat
J
Watthanatham
Department of Radiology, Anandamahidol Hospital, Lopburi 15000,Thailand.
Prateep
P
Napatharatip
Department of Pathology, Phramongkutklao College of Medicine, Bangkok 10400, Thailand.
Sumeth
S
Termmathurapoj
Case report; Giant insulinoma; Insulinoma; Pancreatic neuroendocrine tumor