Endoscopic ultrasound localization of a solitary insulinoma of pancreatic tail misdiagnosed as epilepsy: case report

Abdom Imaging. 2003 Nov-Dec;28(6):859-61. doi: 10.1007/s00261-003-0039-5.

Abstract

A 17-year-old female patient with features of epilepsy was treated with valproic acid. Two years later, hypoglycemia and hyperinsulinemia appeared. Transabdominal ultrasonography, spiral computed tomography, and indium-111 Octreoscan were performed without positive results. Endoscopic ultrasonography identified an oval tumor in the pancreatic tail with a color Doppler hypervascular pattern. Surgical enucleation decreased levels of insulin and C-peptide within 20 min, and the patient became free of symptoms and medications.

MeSH terms

  • Adolescent
  • Anticonvulsants / therapeutic use
  • C-Peptide / blood
  • Diagnostic Errors
  • Endosonography*
  • Epilepsy / diagnosis*
  • Epilepsy / drug therapy
  • Female
  • Humans
  • Insulin / blood
  • Insulinoma / diagnostic imaging*
  • Insulinoma / surgery
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / surgery
  • Valproic Acid / therapeutic use

Substances

  • Anticonvulsants
  • C-Peptide
  • Insulin
  • Valproic Acid