EUS-Guided Radiofrequency Ablation for Pancreatic Insulinoma: A Case Report

Endogenous hyperinsulinemic hypoglycemia remains a diagnostic challenge requiring precise biochemical and imaging evaluation to determine its etiology. Insulinoma, although rare, is the most common functional pancreatic neuroendocrine tumor. It arises from pancreatic beta cells and is characterized by inappropriate insulin secretion, leading to recurrent hypoglycemia. We report the case of a 40-year-old woman with recurrent symptomatic hypoglycemia in whom Whipple’s triad was documented. Endoscopic ultrasound identified a 13 × 12 mm lesion in the pancreatic neck, consistent with insulinoma. Given the clinical and anatomical characteristics, endoscopic ultrasound-guided radiofrequency ablation was performed as a minimally invasive therapeutic alternative. The patient had a favorable short-term outcome, with complete resolution of symptoms, no residual lesion on imaging at 3 months, and normal fasting glucose, insulin, and C-peptide levels at 4 months.