Giant insulinoma in a 15-year-old man: A case report

INTRODUCTION: Giant insulinomas are extremely rare pancreatic neuroendocrine tumor. PRESENTATION OF CASE: A 15-year-old man presenting with acute onset of lightheadedness was found to have serum glucose of 1.5 mmol/L. The blood collected from the hypoglycemic episode showed an inappropriately high insulin and C-peptide level. Abdominal computerized tomography showed a 12.5 cm well-defined, lobulated hypervascular mass at pancreatic tail, without any evidence of metastasis. En bloc resection with distal pancreatectomy, and splenectomy was successfully performed. The pathological examination confirmed insulinoma, with benign characteristics. Follow-up after the procedure revealed neither hypoglycemic, nor hyperglycemia. CONCLUSION: We report the youngest case of a giant insulinoma. Despite the size of the tumor, the pathological report confirmed the benign characteristics. However, long-term follow-up is still essential to detect recurrence in the future.