HWN Suggests

She Was Healthy and Active. Suddenly She Had a Seizure

Having the right amount of glucose — the body’s preferred sugar — in the bloodstream is essential for the body to run normally... Normal measurements for women are above 60. Many of her measurements were in the 40s, and some were as low as the 20s. Patients will often be confused or even unconscious when their blood-glucose levels go as low as hers did.

Why was her glucose dropping this way? The most concerning possibility was that she had a rare insulin-producing tumor, known as an insulinoma.

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Featured

 Picking up an insulinoma – The challenges ahead

We conclude that diagnosing insulinomas may take a longer time in cases where we lack suspicion and newer diagnostic modalities, such as DOTA scan should be made use of as it is less invasive and has more sensitivity in diagnosing these tumours.

Articles of Interest

A rare entity of malignant insulinoma diagnosed after 30 years of clinical manifestation of hypoglycemia: A case report and literature review

Malignant insulinomas, a rare life threatening pathology, exists in literature as an entity that constitutes 10% of all insulinomas and often present as multi-centric macro nodules with multiple lymph nodes or liver metastases before diagnosis.

A Rare Tumor Made A Woman Act Drunk For Years

McGinn, a 54-year-old real estate agent from New York, told Fox News that she "would become very combative, not knowing what I was saying and sway back and forth." But she wasn't drunk. Ever. Her mysterious symptoms lasted years.

Diagnosis and management of insulinoma

Insulinomas, the most common cause of hypoglycemia related to endogenous hyperinsulinism, occur in 1-4 people per million of the general population. Common autonomic symptoms of insulinoma include diaphroresis, tremor, and palpitations, whereas neuroglycopenenic symptoms include confusion, behavioural changes, personality changes, visual disturbances, seizure, and coma.

Diagnostic Dilemma in a Patient With Insulinoma

Hypoglycemia is a fairly frequent reason for referral, but insulinoma is rare, with an estimated incidence of four per 1 million, making clinical suspicion extremely important in diagnosis.

Evolving management of insulinoma: Experience at a tertiary care centre

Since our previous study in 2006, several new modalities for localization of cause of endogenous hyperinsulinemic hypoglycaemia such as multiphasic computed tomography (CT), multiphasic magnetic resonance imaging (MRI), endoscopic ultrasound (EUS), intraoperative ultrasound, and intra-arterial calcium infusion with arterial stimulation venous sampling (ASVS) have become available.

Insulinoma

Insulinoma is a rare neuroendocrine tumor with an incidence of 4 per 1 million persons per year.1 Insulinoma may occur as a unifocal sporadic event in patients without an inherited syndrome or as a part of multiple endocrine neoplasia type

Insulinoma - Causes, Symptoms, Diagnosis, and Treatment

People affected by Von Hippel-Lindau disease (VHL) are at higher risk of developing insulinoma because this disease causes tumors and cysts to form throughout the body.

Insulinoma historical perspective

In 1869, pancreatic islet cells were discovered by Paul Langerhans. The first adenoma of islets was discovered by Nicholls in 1902. Insulin was first discovered by Banting and Best in 1922. Association between hyperinsulinism and functional islet tumor was described in 1926 by Wilder. In 1927, the insulinoma was first described in Mayo clinic which was dissected in 1929 in Toronto. In 1929, the first surgical cure was performed by Roscoe Graham. In 1935, Whipple suggested a diagnostic criterion for the diagnosis of insulinoma called as Whipple's triad.

Insulinoma- A complicated presentation in a rare case scenario

Insulinoma is a tumour of the endocrine pancreas, usually benign, with an annual incidence of 1–2 new cases per million population. We describe a case of Insulinoma complicated by the simultaneous development of diabetes.

Think Like a Doctor: Sugar-Free

An insulinoma is a rare tumor of pancreatic tissue that makes and secretes insulin independently of blood glucose levels. This results in episodes of hypoglycemia that can be quite severe, even life-threatening. The diagnosis is suspected when a patient fulfills what is known as Whipple’s triad: 1) symptoms of hypoglycemia 2) associated with low measured blood sugar and 3) which improve when blood sugar is raised to the normal range.

Resources

Radiopaedia.org

These tumors can be relatively small and multiphase contrast-enhanced thin slice cross-sectional imaging is ideal. Most insulinomas are small (90% are <2 cm at presentation) and hypervascular. They may contain calcifications. Malignant tumors tend to be larger. Insulinomas are equally distributed between the head, body, and tail of the pancreas.

StatPearls

Insulinoma is a type of functional neuroendocrine tumor characterized by hypersecretion of insulin, causing hypoglycemia. It typically presents as a solitary benign tumor but can be associated with multiple endocrine neoplasia type 1 (MEN1).