Gowda Smitha Narayana, Abdullah Hafez Mohammad, Sethi Prince, Cunningham Arwyn, Askeland Ryan, Oliver Tony
Internal Medicine Residency Program, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
Pathology Residency Program, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
S D Med. 2019 Dec;72(12):552-555.
Insulinomas are rare neuroendocrine tumors that produce excessive insulin and result in hypoglycemia. It can have a wide spectrum of symptoms and presentations which makes it difficult to diagnose at times. Here we present a 39-year-old woman who presented with intermittent diplopia, confusion, and staring episodes for one month. She had previously been seen by a neurologist who diagnosed her with possible absence seizures. However, evaluation showed that that patient had severe hypoglycaemia even with dextrose infusions. She was diagnosed with insulinoma based on lab work and a biopsy of a pancreatic tail mass. She underwent partial pancreatectomy, and has had a good outcome, with no recurrence of her symptoms. This case highlights the variable presentation of insulinomas, and the challenges faced with its diagnosis.
胰岛素瘤是一种罕见的神经内分泌肿瘤，可分泌过多胰岛素并导致低血糖。其症状和表现多种多样，有时难以诊断。在此，我们报告一名39岁女性，她出现间歇性复视、意识模糊和凝视发作1个月。她之前看过神经科医生，被诊断可能患有失神发作。然而，检查发现即使输注葡萄糖，该患者仍有严重低血糖。根据实验室检查结果和胰腺尾部肿块活检，她被诊断为胰岛素瘤。她接受了胰腺部分切除术，术后恢复良好，症状未复发。本病例突出了胰岛素瘤表现的多样性及其诊断面临的挑战。
