Case report of a pancreatic insulinoma misdiagnosed as epilepsy

BMJ Case Rep. 2021 May 19;14(5):e238238. doi: 10.1136/bcr-2020-238238.

Abstract

A 55-year-old patient had spent 12 years with unexplained seizures, initially diagnosed as epilepsy and then as a psychiatric disorder. When she was admitted with hypoglycaemia, a fasting test was performed showing blood sugar levels as low as 1 mmol/L with symptoms of neuroglycopenia. Insulinoma was suspected and an MRI showed a large tumour in the tail region of the pancreas. A Dodecanetetraacetic acid-Tyr3-octreotate (DOTATATE) positron emission tomography CT indicated no malignancy and showed no signs of metastasis. The patient underwent surgery, leaving her asymptomatic.

Keywords: endocrine cancer; endocrinology; epilepsy and seizures; general surgery.

Publication types

  • Case Reports

MeSH terms

  • Diagnostic Errors
  • Epilepsy*
  • Female
  • Humans
  • Insulinoma* / diagnostic imaging
  • Insulinoma* / surgery
  • Middle Aged
  • Pancreatic Neoplasms* / diagnostic imaging
  • Tomography, X-Ray Computed