Insulinoma

Cell of origin ; Beta cell of pancreas
Clinical manifestations
    • Inappropriately elevated insulin levels cause neuroglycopenic and sympathetic symptoms
Laboratory studies
    • Supervised 72 hours fasting test
      • Fasting serum hypoglycemia (≤ 40 mg/dl)
      • Concomitant hyperinsulinemia (≥ 6 microunits/ml)
      • Absence of insulin antibodies
Imaging studies
    • Non invasive
      • Transabdominal USG
      • CT abdomen
    • Invasive
      • Endoscopic ultrasound
      • Selective arterial stimulation and venous sampling
Management
    • Enucleation of the tumor or distal pancreatectomy