ECE2022 Eposter Presentations Endocrine-Related Cancer (61 abstracts)
Insulinoma with confusing imaging : a case report
Wafa Belabed , Fatma Mnif , Abdelmouhaymen Missaoui , Dhoha Ben Salah , Faten Haj Kacem Akid , Elleuch Mouna , Mouna Mnif , Nadia Charfi , Nabila Mejdoub & Mohamed Abid
Hedi Chaker University Hospital, Endocrinology Department, Sfax, Tunisia
Introduction: Insulinoma is a rare pancreatic tumor. It is the most frequent cause of organic hypoglycemia due to endogenous hyperinsulinism.
Case report: A 55-year-old woman was admitted in our department for the management of a recurrent hypoglycemic coma. Endogenous hyperinsulinic hypoglycemia was confirmed with a spontaneous hypoglycemia. Plasma blood glucose was 0.25 g/l concomitant to a high insulinemia of 31.5 µUI/ml (≥ 3) and C-peptide level of 3.16 ng/ml (≥ 0.6) In imaging investigations, abdominal CT scan and endoscopic ultrasound were both normal. A complementary nuclear imaging by Octreoscan was performed and detected the presence of 2 pancreatic lesions: one in the uncinate process and the other in the tail. Abdominal MRI was performed and concluded to the presence of a unique lesion of the pancreas tail. Our patient was then proposed for surgery of the two insulinomas. Per-operative exploration concluded to the presence of a single corporal tumor mass of the pancreas of 1.5 cm. A left pancreatectomy was then performed. Our patient had resolution of symptoms after surgery. The follow-up is 6 months to date.
Conclusion: This case highlights the difficulty of the radiological identification of small pancreatic lesions leading to a multitude of imaging investigations. Our experience also highlighted that the 111In-DTPA-octreotide uptake in pancreatic uncinate process may be physiological and its interpretation must, therefore, be cautious.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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