Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2011) 25 P99


1St James’ Hospital, Dublin, Ireland; 2St Vincent’s University Hospital, Dublin, Ireland.

Introduction: Insulinoma is a tumour, derived from the beta cells of the pancreas. The incidence in the general population is 4 cases per million a year. 80 to 90% of insulinomas are benign and <10% are malignant.

Case presentation: A 67-year-old lady was admitted via the emergency department after being found unresponsive at home. She was found to be hypoglycaemic and responded to i.v. dextrose. She was diagnosed with type 2 diabetes mellitus a year ago and had been suffering from episodes of confusion and has had significant weight loss over 1 year. A 72 h fast test was stopped after two hours as she suffered another episode of hypoglycemia. Laboratory investigations revealed low blood glucose and elevated C Peptide levels and elevated insulin levels. She underwent CT Abdomen and Endoscopic Ultrasound which revealed a 6 cm pancreatic hypoechoic lesion and large volume right sided liver metastases. Ultrasound guided biopsy confirmed a pancreatic neuroendocrine tumour. The patient underwent successful one-step RO surgical resection – distal pancreatectomy, splenectomy and right hepatectomy and was recurrence free 12 months post operatively. Her only residual problem is diabetes mellitus.

Conclusion: This case highlights a rare cause of hypoglycemia in a diabetic patient. Medical treatment with diazoxide and somatostatin analogues can be used until oncological resection. Surgical resection of insulinomas remain the main curative treatment where possible.

Article tools

My recent searches

No recent searches.