Epilepsy-mimicking pancreatic insulinoma
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Martínez-Montalvo, C. M., Muñoz-Delgado, D. Y., Rodríguez-Bolaños, J. H., Medina-Quintana, J. C., Tobón-Arango, J. M., Castiblanco-Cabezas, G. P., Conrado-Jiménez, H., & Siado, S. A. (2021). Epilepsy-mimicking pancreatic insulinoma. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 7(3), 194–198. https://doi.org/10.53853/encr.7.3.633


An insulinoma is a rare secretory endocrine neoplasm that causes a hypoglycemic hyperinsulinemic state derived from the absence of endocrine regulation of insulin secretion. Its worldwide incidence is 1 to 5 cases per million individuals every year. Neuroglycopenic and sympathetic adrenal symptoms are the most common clinical manifestations. Also, diagnosis is established by Whipple’s triad, together with the finding of inappropriately high levels of insulin, C peptide, proinsulin, and beta-hydroxybutyrate. Surgical resection is the first line of management choices, given its benign features and high recovery rates. The aim of this report is to present the case of male patient with a history of misdiagnosed epilepsy refractory to anticonvulsant management, who presented with an episode of severe hypoglycemia and was subsequently diagnosed with insulinoma that improved with surgical management.

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1. Nessa A, Rahman SA, Hussain K. Hyperinsulinemic Hypoglycemia – The Molecular Mechanisms. Front Endocrinol (Lausanne). 2016;7(29). doi: 10.3389/fendo.2016.00029
2. Matej A, Bujwid H, Wronski J. Glycemic control in patients with insulinoma. Hormones (Athens). 2016;15(4):489-99. doi: 10.14310/horm.2002.1706
3. Service FJ, McMahon MM, O’Brien PC, Ballard DJ. Functioning insulinoma- -incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin Proc. 1991;66(7):711-9. doi: 10.1016/s0025-6196(12)62083-7
4. Iglesias P, Díez JJ. Management of endocrine disease: a clinical update on tumor-induced hypoglycemia. Eur J Endocrinol. 2014;170(4):R147-57. doi: 10.1530/EJE-13-1012
5. Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y, et al. Diagnosis and management of insulinoma. World J Gastroenterol. 2013;19(6):829- 37. doi: 10.3748/wjg.v19.i6.829
6. Kittah NE, Vella A. Management of endocrine disease: Pathogenesis and management of hypoglycemia. Eur J Endocrinol. 2017;177(1):R37-r47. doi: 10.1530/EJE-16-1062
7. Rostambeigi N, Thompson GB. What should be done in an operating room when an insulinoma cannot be found? Clin Endocrinol (Oxf). 2009;70(4):512-5. doi: 10.1111/j.1365-2265.2009.03527.x
8. Falconi M, Eriksson B, Kaltsas G, Bartsch DK, Capdevila J, Caplin M, et al. ENETS Consensus Guidelines Update for the Management of Patients with Functional Pancreatic Neuroendocrine Tumors and Non-Functional Pancreatic Neuroendocrine Tumors. Neuroendocrinology. 2016;103(2):153- 71. doi: 10.1159/000443171
9. Harris S. Hyperinsulinism, a definite disease entity: etiology, pathology, symptoms, diagnosis, prognosis, and treatment of spontaneous insulogenic hypoglycemia (hyperinsulinism). JAMA. 1933;101(25):1958-65. doi:10.1001/jama.1933.02740500038010
10. Beisang D, Forlenza GP, Luquette M, Sarafoglou K. Sporadic Insulinoma Presenting as Early Morning Night Terrors. Pediatrics. 2017;139(6):e20162007. doi: 10.1542/peds.2016-2007
11. Chirinos-Revilla JL, Fernandez-Sivincha JG. [Insulinoma found in a patient with apparent mental disorder: a case report]. Rev Gastroenterol Peru. 2018;38(1):82-4.
12. Wexler DJ, Macias-Konstantopoulos W, Forcione DG, Xiong L, Cauley CE, Pierce KJ. Case 23-2018: A 36-Year-Old Man with Episodes of Confusion and Hypoglycemia. N Engl J Med. 2018;379(4):376-85. doi: 10.1056/ NEJMcpc1802828
13. Murakami T, Yamashita T, Yabe D, Masui T, Teramoto Y, Minamiguchi S, et al. Insulinoma with a History of Epilepsy: Still a Possible Misleading Factor in the Early Diagnosis of Insulinoma. Intern Med. 2017;56(23):3199-204. doi: 10.2169/internalmedicine.8932-17
14. Dizon AM, Kowalyk S, Hoogwerf BJ. Neuroglycopenic and other symptoms in patients with insulinomas. Am J Med. 1999;106(3):307-10. doi: 10.1016/s0002-9343(99)00021-2
15. Correia P, Panchani R, Ranjan R, Agrawal C. Insulinoma presenting as a refractory seizure disorder. F1000Res. 2012;1:15. doi: 10.12688/f1000research.1-15.v1.
16. Tesfaye N, Seaquist E. Neuroendocrine response to hypoglycemia. Ann N Y Acad Sci. 2010;1212:12-28. doi: 10.1111/j.1749-6632.2010.05820.x
17. Ro C, Chai W, Yu VE, Yu R. Pancreatic neuroendocrine tumors: biology, diagnosis, and treatment. Chin J Cancer. 2013;32(6):312-24. doi: 10.5732/ cjc.012.10295
18. Miron I, Diaconescu S, Aprodu G, Ioniuc I, Radu M, Miron L. Diagnostic difficulties in a pediatric insulinoma: a case report. Medicine. 2016;95(11):e3045. doi: 10.1097/MD.0000000000003045
19. Pinzón-Tovar A, Yucumá-Gutiérrez S. Hiperinsulinismo endógeno diagnosticado como epilepsia. Rev Col Endocrinol Diab Metab. 2016;3(1):51-55.

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