You are not yourself when you are hungry: a rare case of malignant insulinoma

Authors

  • Maria Joao Amaral Department of General Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal Faculty of Medicine, University of Coimbra, Coimbra, Portugal http://orcid.org/0000-0002-7494-3218
  • Henrique Alexandrino Department of General Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal Faculty of Medicine, University of Coimbra, Coimbra, Portugal Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  • Daniela Meireles Department of Internal Medicine, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
  • Rui Caetano Oliveira Department of Pathology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Marco Serodio Department of General Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  • Jose Guilherme Tralhao Department of General Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal Faculty of Medicine, University of Coimbra, Coimbra, Portugal Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal

DOI:

https://doi.org/10.18203/2349-2902.isj20202852

Keywords:

Hypoglycaemia, Neurobehavioral manifestations, Neuroendocrine carcinoma, Insulinoma

Abstract

We present a rare case of high-grade functional neuroendocrine carcinoma of the pancreas secreting insulin. Our patient, an 80 years old woman, presented with neuropsychiatric symptoms consistent with hypoglycaemia that regressed with food intake and dextrose administration. Abdominal imaging showed a pancreatic tumour with invasion of the spleen and lymph node metastasis, highly suggestive of an insulinoma as the cause of the hypoglycaemia. The patient underwent left pancreatectomy with splenectomy and atypical gastric resection. The postoperative course of our patient was uneventful, with complete remission of the hypoglycaemic episodes, and the definitive histological examination showed three poorly differentiated large cell neuroendocrine carcinomas of the pancreas.

References

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Published

2020-06-25

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Section

Case Reports