The Medical and Surgical Management of Recurrent Multicenter Insulinomatosis Without Known Genetic Predisposition

ACG Case Rep J. 2024 May 13;11(5):e01350. doi: 10.14309/crj.0000000000001350. eCollection 2024 May.

Abstract

Insulinomas are rare neuroendocrine tumors characterized by episodic hypoglycemia. Typically, insulinomas are benign, solitary, intrapancreatic, and measure less than 2 cm in diameter. When insulinomas are multicenter or recurrent, they are often associated with genetic conditions such as multiple endocrine neoplasia type 1, neurofibromatosis type 1, or von Hippel-Lindau disease. Most insulinomas can be resolved with surgery. Multicenter and recurrent insulinomas, known as insulinomatosis, may require additional medical and surgical management. We report a distinctive case involving recurrent multicenter insulinomatosis devoid of any identified genetic familial predisposition. The patient's complex medical history spans nearly 2 decades, marked by unsuccessful attempts at resolution through surgical enucleation and noninvasive medical management, culminating in the decision for total pancreatectomy.

Keywords: insulinoma; insulinomatosis; pancreatectomy.

Publication types

  • Case Reports