PMC10436085_01
Metabolic profile of the patient. (A) Before surgical treatment (continuous lines). (B) After surgical treatment (dotted lines). The gray bands represent normal range of the analytes (vertical axis). Horizontal axis represents time (numbers refers to the days before and after surgical removal of the insulinoma). E. R., Emergency Room.
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F1
Intermittent blood glucose monitoring during the fasting test revealed alternating episodes of hypoglycemia, accompanied by distinct metabolic features consistent with hyperinsulinism (Figure 1A). Laparoscopic distal pancreatectomy allowed the excision of the insulinoma and the full correction of clinical and metabolic picture (Figure 1B).
Imaging of insulinoma. (A) MRI showing a lesion in the pancreatic tail. (B) 68Ga-DOTATOC PET/CT scan showing selective radiotracer uptake by the lesion consistent with insulinoma.
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F2
An abdominal multiphase computed tomography (CT) scan revealed an arterial phase enhancing lesion (maximum diameter 29 mm) at the pancreas tail, which was further confirmed by magnetic resonance imaging (MRI). 68Ga-DOTATOC positron emission tomography/computed tomography (PET/CT) imaging demonstrated selective radiotracer uptake by the lesion, consistent with insulinoma (Figures 2A,B).