Insulinoma: diagnosis and management
Aguiló, F.; Rabell, V.M.; Allende, M.; Vázquez Quintana, E.
Boletin de la Asociacion Medica de Puerto Rico 72(9): 455-465
1980
ISSN/ISBN: 0004-4849 PMID: 6252912 Document Number: 700036
A 60 yr old white female had episodes of dizziness, increased sweating and loss of consciousness which were relieved by food ingestion. She had gained 20 lb in the preceding 18 mo. For 8 yr she had been treated for psychiatric manifestations. After a diabetes screening she was placed on a weight reduction diet which aggravated her symptoms. Fasting hypoglycemia (22 mg/dL) and hyperinsulinism (up to 1400 .mu.U/ml) were documented. At celiac arteriography, a well defined mass was seen in the tail of the pancreas, which proved to be an insulinoma at operation. Postoperatively she developed a pesudocyst which resolved without operation. Persistent hyperglycemia (up to 276 mg/dL fasting) and glycosuria were not responsive to sulfonylureas. After almost achieving ideal body weight, she was prescribed 20 units of insulin daily, a treatment which she still follows.