Insulinoma: A Diagnostic Challenge!

Abstract

Insulinoma is a common tumour arising from islets of Langerhans. Patients with insulinomas present with neuroglycopenic symptoms such as repeated episodes of headache, blurred vision, diplopia and lethargy especially with fasting or exercise. Seizures, coma and permanent brain damage results from severe hypoglycaemia. The present report is of a female who got admitted with the chief complaints of swaying on to one side since one month and slurring of speech, seizures and becoming drowsy for four days. Her laboratory values indicated repeated episodes of hypoglycaemia in spite of repeated administration of intravenous dextrose. A CT scan of pancreas revealed insulinoma and was treated by surgical resection. After surgery, patient’s symptoms subsided and she recovered well. The clinical manifestations of insulinoma mimic features of diabetes mellitus and neuropsychiatric disorders, hence a thorough investigation needs to be done to confirm the diagnosis.

Keywords

• hypoglycaemia
• neuroglycopenic symptoms
• pancreatic neoplasm
• pancreatic tumour
• resection