Insulinoma. Case report

Insulinoma. Case report

I.V. Druk¹, S.S. Safronova¹, E.N. Podolsky², A.A. Marikyan², A.G. Shimanskaya¹, S.I. Mozgovoy¹, S.B. Glatko³, A.V. Kononov¹, O.O. Mironova², I.I. Minaev³, A.Yu. Hamburg¹ 

¹Omsk State Medical University, Omsk

²West Siberian Medical Center of Federal Medical-Biological Agency of Russian Federation, Omsk

³Clinical Oncological Dispensary, Omsk 

Insulinoma is the most common pancreatic neuroendocrine tumor that causes the development of a hypoglycemia due to endogenous hyperinsulinism. In 85-90% of cases, insulinoma is a solitary benign tumor. Multiple synchronous or metachronous insulinomas can occur in multiple endocrine neoplasia type 1. The gold standard of diagnostics is a 72-hour fast, the purpose of which is to provoke the pathognomonic Whipple’s triad. Imaging techniques include computed tomography, magnetic resonance imaging, transabdominal and endoscopic ultrasound, and molecular imaging techniques. The radical treatment method is surgical, namely, tumor enucleation or pancreatectomy. The operation in the vast majority of cases provides a complete cure. Conservative treatment tactics are considered when the patient’s health condition significantly increases the risk of surgical intervention. The article presents a description concerning the clinical case of insulinoma, demonstrating the standard course of benign insulinoma, the information value of the main laboratory and instrumental methods of diagnostic search, including typical results of a fasting test, the first stage of imaging and immunohistochemistry, as well as the efficacy of surgical treatment as a method of treatment tactics for solitary benign insulinoma. Organic hyperinsulinism masked the clinical manifestations of type 2 diabetes mellitus in a patient with risk factors.

Keywords: neuroendocrine tumors, endogenous hyperinsulinism, insulinoma, pancreas, diagnosis, treatment.

For citation: Druk I.V., Safronova S.S., Podolsky E.N. et al. Insulinoma. Case report. RMJ. 2023;2:25–32.