Lessons to be learned: a case study approach insulinoma presenting as a change in personality

The Journal of the Royal Society for the Promotion of Health
S VigA Stacey-Clear

Abstract

A 43-year-old man presented with attacks of altered behaviour over a short period of time; they were associated with episodes of hypoglycaemia. The clinical suspicion of insulinoma prompted investigations that quickly established serum insulin and C-peptide levels to be elevated at the times when blood glucose values were low. A physical lesion was found in the head of the pancreas by means of computerised tomography and endo-duodenal ultrasound scan; an octreotide scan was negative. The patient underwent laparotomy and enucleation of a benign tumour, measuring 2.6 cm in diameter, lying within the head of the pancreas; histological examination confirmed it to be an insulinoma. Postoperatively, the patient's personality gradually became more normal and his fasting blood glucose concentrations returned to within normal limits. The diagnosis and management of insulinoma are discussed in the context of this clinical case; there is also reference to the protean clinical manifestations that may occur in this condition- and its differential diagnosis.

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Citations

Jul 10, 2013·International Psychogeriatrics·Susana RencaJoaquim Cerejeira
Nov 12, 2015·Case Reports in Surgery·Yavuz Savas KocaMehmet Numan Tamer
Sep 20, 2007·Science in China. Series C, Life Sciences·SiJiu YuJiangFeng Fan
Jul 14, 2006·American Journal of Community Psychology·Stephen L SchensulRavi K Verma
Jun 12, 2018·Nigerian Journal of Clinical Practice·U R EbubedikeS N C Anyanwu
Sep 21, 2005·Arquivos de neuro-psiquiatria·Carlos Alexandre TwardowschyMichelle Totti Dykyj
Dec 12, 2019·Expert Review of Anticancer Therapy·Elisabeth HainSébastien Gaujoux

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