CASE 582: INSULINOMA, Dr PHAN THANH HAI, Dr HUYNH TRAC LUAN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

WOMAN  25YO  with  HYPOGLYCEMIA COMA MANY TIMES  IN EMERGENCY  HOSPITAL.   

AT MEDIC, BLOODTESTS:  

FASTING GLUCOSE  (FPG) = 2.4  (N=3.9-5.9 mmol/mL)    

Insuline=   71.3  ( N= 2.6-24.9 microUI/mL) 

C-PEPTIC FASTING = 7.45 ng/mL (N =1.1-4.4 mUI/mL)

BLOOD TEST RESULTS SUSPECTED INSULINOMA.  

ULTRASOUND of  PANCREAS IS NORMAL  BUT SMALL ACCESSORY  SPLEEN EXISTS (US 1, US 2, US 3).

MSCT SPECTRAL CONTRAST of PANCREAS  NON DETECTED PANCREAS TUMOR BUT CLEARLY VIEWING ACCESSORY SPLEEN (CT1/CT2).

MRI of PANCREAS   DETECTED  SMALL TUMOR AT THE TAIL of PANCREAS #1.5 CM  SUSPECTED  INSULINOMA.

Operation removed small tumor at the tail of pancreas  (ope, macro1, macro2).

MICROSCOPIC REPORT IS  ENDOCRINE PANCREATIC  ADENOMA  (INSULINOMA).

CONCLUSION = CASE OF TYPICAL INSULINOMA IN CLINICAL   BUT ULTRASOUND and CT CANNOT DETECT THIS SMALL TUMOR, EXCEPT MRI.

Reference    CT perfusion of pancreas  detected insulinoma.