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An Unusual Presentation of Insulinoma: Confusion With Psychiatric Symptoms

Insulinoma is a rare but common functional neuroendocrine tumor that secretes an excess amount of insulin resulting in mostly fasting hypoglycemia but can also cause postprandial hypoglycemia. It usually presents with neuroglycopenic and autonomic sympathetic symptoms that resolve following the admi...

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Detalles Bibliográficos
Autores principales: Ataallah, Basma, Abdulrahman, Mustafa, Haggerty, Gregory
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383564/
https://www.ncbi.nlm.nih.gov/pubmed/34434385
http://dx.doi.org/10.14740/jmc3477
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author Ataallah, Basma
Abdulrahman, Mustafa
Haggerty, Gregory
author_facet Ataallah, Basma
Abdulrahman, Mustafa
Haggerty, Gregory
author_sort Ataallah, Basma
collection PubMed
description Insulinoma is a rare but common functional neuroendocrine tumor that secretes an excess amount of insulin resulting in mostly fasting hypoglycemia but can also cause postprandial hypoglycemia. It usually presents with neuroglycopenic and autonomic sympathetic symptoms that resolve following the administration of dextrose. The patients may remain symptomatic from 1 week to as long as several decades before diagnosis. Insulinoma presenting with psychiatric symptoms has been documented in case/case series reports. Laboratory findings of elevated insulin and C-peptide level in the presence of hypoglycemia and absence of plasma sulfonylurea are suggestive of the diagnosis. Localization of the tumor is essential preoperatively. Surgery usually cures most of the patients, but a minority will have a recurrence especially with malignant insulinoma. The manuscript presents a case of insulinoma presenting with psychiatric symptoms without sympathetic symptoms that led to the delay of the diagnosis for 3 months as initially thought to be related to psychiatric problems. Pancreatic insulinoma was localized by computed tomography (CT) scan and confirmed with endoscopic ultrasound (EUS). The patient underwent successful resection of the tumor, and her symptoms were completely resolved.
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spelling pubmed-83835642021-08-24 An Unusual Presentation of Insulinoma: Confusion With Psychiatric Symptoms Ataallah, Basma Abdulrahman, Mustafa Haggerty, Gregory J Med Cases Case Report Insulinoma is a rare but common functional neuroendocrine tumor that secretes an excess amount of insulin resulting in mostly fasting hypoglycemia but can also cause postprandial hypoglycemia. It usually presents with neuroglycopenic and autonomic sympathetic symptoms that resolve following the administration of dextrose. The patients may remain symptomatic from 1 week to as long as several decades before diagnosis. Insulinoma presenting with psychiatric symptoms has been documented in case/case series reports. Laboratory findings of elevated insulin and C-peptide level in the presence of hypoglycemia and absence of plasma sulfonylurea are suggestive of the diagnosis. Localization of the tumor is essential preoperatively. Surgery usually cures most of the patients, but a minority will have a recurrence especially with malignant insulinoma. The manuscript presents a case of insulinoma presenting with psychiatric symptoms without sympathetic symptoms that led to the delay of the diagnosis for 3 months as initially thought to be related to psychiatric problems. Pancreatic insulinoma was localized by computed tomography (CT) scan and confirmed with endoscopic ultrasound (EUS). The patient underwent successful resection of the tumor, and her symptoms were completely resolved. Elmer Press 2020-05 2020-05-03 /pmc/articles/PMC8383564/ /pubmed/34434385 http://dx.doi.org/10.14740/jmc3477 Text en Copyright 2020, Ataallah et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Ataallah, Basma
Abdulrahman, Mustafa
Haggerty, Gregory
An Unusual Presentation of Insulinoma: Confusion With Psychiatric Symptoms
title An Unusual Presentation of Insulinoma: Confusion With Psychiatric Symptoms
title_full An Unusual Presentation of Insulinoma: Confusion With Psychiatric Symptoms
title_fullStr An Unusual Presentation of Insulinoma: Confusion With Psychiatric Symptoms
title_full_unstemmed An Unusual Presentation of Insulinoma: Confusion With Psychiatric Symptoms
title_short An Unusual Presentation of Insulinoma: Confusion With Psychiatric Symptoms
title_sort unusual presentation of insulinoma: confusion with psychiatric symptoms
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383564/
https://www.ncbi.nlm.nih.gov/pubmed/34434385
http://dx.doi.org/10.14740/jmc3477
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