Insulinoma is the most common neuroendocrine tumor of the pancreatic islet cell, but malignant insulinoma is rare. This tumor secretes insulin or less commonly proinsulin, which results in systemic symptoms related to hypoglycemia. Patients typically ...
Insulinoma is the most common neuroendocrine tumor of the pancreatic islet cell, but malignant insulinoma is rare. This tumor secretes insulin or less commonly proinsulin, which results in systemic symptoms related to hypoglycemia. Patients typically present with neuroglycopenia or autonomic symptoms associated with hypoglycemia. We report a case of large malignant insulinoma in a 49-year-old woman. Her hypoglycemia related main symptom is syncope. A presumptive clinical diagnosis was done before surgery,based on the high plasma insulin-to-glucose ratio, high plasma insulin level,hypoglycemia and related symptom. A large solitary pancreatic mass detected by abdominal computed tomography. The tumor measured 7x5x3,5cm in dimension and showed histologically capsular and vascular invasion. She was treated by distal pancreatectomy with splenectomy and rapidly recovered without hypoglycemic symptoms.