Table of Contents Author Guidelines Submit a Manuscript
International Journal of Endocrinology
Volume 2011 (2011), Article ID 124078, 5 pages
http://dx.doi.org/10.1155/2011/124078
Case Report

Metastatic Insulinoma in a Patient with Type 2 Diabetes Mellitus: Case Report and Review of the Literature

1Department of Endocrinology, St. James' Hospital, Dublin 8, Ireland
2Department of Endocrinology, St. Vincent's University Hospital, Dublin 4, Ireland
3Department of Surgery, St. Vincent's University Hospital, Dublin 4, Ireland
4Department of Pathology, St. James' Hospital, Dublin 8, Ireland
5Department of Pathology, St. Vincent's University Hospital, Dublin 4, Ireland
6Department of Gastroenterology, St. James' Hospital, Dublin 8, Ireland

Received 3 November 2010; Accepted 5 January 2011

Academic Editor: A. L. Barkan

Copyright © 2011 Noormuhammad Oosman Abbasakoor et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pancreatic neuroendocrine tumors (NETs) are extremely rare, and although insulinomas are the commonest, less than 10% of insulinomas are malignant. Most patients with insulinomas present with neuroglycopenic symptoms and weight gain attributable to insulin excess. Here, we report a case where a 67-year-old lady with a background history of type 2 diabetes mellitus and breakthrough hyperinsulinism who presented with coma. The biochemical profile revealed features typical of insulinoma, and CT and endosonography confirmed a pancreatic tumor with large volume right-sided liver metastases (biopsy confirming a neuroendocrine tumor). The patient underwent successful one-step RO surgical resection, distal pancreatectomy, splenectomy, and right hepatectomy, and 9 months postoperatively, she remains free of recurrent disease. She remains a diabetic.