Patient with neuropsychiatric symptoms and insulinoma of difficult preoperative localization

Abstract

This paper describes the case of a patient with neuropsychiatric<br />symptoms who was diagnosed with hyperinsulinemic<br />hypoglycemia with high suspicion of insulinoma, even after<br />conventional diagnostic imaging was unable to locate it. A<br />selective angiography of the pancreatic arteries and a calcium<br />stimulation test were conducted to determine its location.<br />The patient underwent a distal pancreatectomy using an<br />intraoperative ultrasound, resulting in the disappearance of<br />her symptoms.

Insulinoma presenting with postprandial hypoglycemia and a low body mass index: A case report

“…Delay in the diagnosis of insulinoma is common because the symptoms largely precede the occurrence of an apparent tumor, and there may be misattribution of the symptoms to psychiatric, cardiac or neurological disorders[ 23 ]. Several studies confirmed that 20%–64% of patients are misdiagnosed with a psychiatric, seizure or other neurological disorder before the final diagnosis of insulinoma is made[ 24 , 25 ]. The interval between the onset of symptoms and the diagnosis of insulinoma ranges from 1 mo to 30 years, with a median of 24 mo; only 28% of patients are diagnosed within 1 year of symptom onset, and the diagnosis is delayed beyond 5 years in 19% of patients[ 19 ].…”

Descripción de la experiencia en pacientes diagnosticados con insulinoma. Estudio multicéntrico en Medellín, Colombia

“…La rareza relativa de esta entidad explica la escasez de reportes locales en la literatura. Los estudios publicados en Colombia están limitados a reportes con un número pequeño de casos y procedentes de un solo centro hospitalario (6)(7)(8)(9) . Se desconoce en la actualidad la experiencia local en relación con el diagnóstico y tratamiento de esta entidad.…”