A rare finding of a rare disease : a case report of a giant insulinoma

Abstract

A 76-year-old woman presented with recurrent episodes of loss of consciousness, her blood glucose being 2.8 mmol/L (range, 3.9Y9.0 mmol/L). She was not having any hypoglycemic agents. Insulin and C-peptide levels taken during the hypogly cemic event (blood glucose, 2.67 mmol/L) demonstrated raised insulin levels (78 mU/ mL; range, 2.6Y25 mU/mL) and C-peptide (17.4 ng/mL; range, 1.1Y4.4 ng/mL). A computed tomographic scan of the abdo men showed a large vascular mass with cystic components arising from the tail of the pancreas. No lymphadenopathy or liver metastases were present (Fig. 1). Subcutaneous octreotide at a dose of 200 Hg three times a day was required to obtain normoglycemia.