Malignant Insulinoma: Case Report and Literature Review

Insulinoma is a neuroendocrine tumor of the pancreas capable of secreting insulin.They are rare and the incidence varies according to the center considered.Fasting hypoglycemia in a non-diabetic patient (blood glucose below 55 mg/dl) is the most common clinical manifestation of insulinoma and the presence of neuroglycopenic symptoms that may be preceded by autonomic symptoms.The diagnosis of insulinoma requires inappropriately high levels of insulin and C-peptide, associated with hypoglycemia.After the biochemical diagnosis, the tumor must be located by imaging techniques such as ultrasound and computed tomography of the abdomen.Malignant tumors have little or no cellular pleomorphism, hyperchromasia or high mitotic activity, tend to have a worse prognosis and the management of hypoglycemia, as well as the resolution of associated metastases, is a challenge.The benefit of primary tumor resection in patients with metastatic pancreatic neuroendocrine tumors is also controversial.