PMID- 32577326
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 12
IP  - 5
DP  - 2020 May 20
TI  - Imaging and Diagnostic Challenges in a Patient With Refractory Hypoglycemia 
      Caused by Insulinomas Related to Multiple Endocrine Neoplasia Type 1.
PG  - e8208
LID - 10.7759/cureus.8208 [doi]
LID - e8208
AB  - Insulinoma is a rare neuroendocrine tumor. It may occur sporadically or as part 
      of the genetic tumor syndrome multiple endocrine neoplasia type 1 
      (MEN1). Diagnosis is challenging because of the small size of insulin producing 
      tumors that lead to hyperinsulinemia. Advances in imaging modalities may provide 
      more accurate diagnosis of primary tumors, metastasis, and tumor functional 
      status. Advances allow for improved medical and surgical management with new 
      tools for research of neuroendocrine tumors. Surgical excision of the primary 
      tumor is often curative; however, insulinomas in MEN1 syndrome are often 
      multifocal with a high rate of recurrence presenting unique challenges in 
      management. Here, we present the case of a 34-year-old male with recurrent 
      hypoglycemic episodes and hyperparathyroidism diagnosed with multiple pancreatic 
      insulinomas secondary to MEN1. Furthermore, we provide a brief review of the 
      literature and discuss the approach to diagnosis and management in patients with 
      MEN1 syndrome and future areas of investigation.
CI  - Copyright (c) 2020, Nance et al.
FAU - Nance, Michael E
AU  - Nance ME
AD  - Internal Medicine, University of Missouri, Columbia, USA.
FAU - Verma, Ritika
AU  - Verma R
AD  - Internal Medicine, University of Missouri, Columbia, USA.
FAU - DeClue, Cory
AU  - DeClue C
AD  - Internal Medicine, University of Missouri, Columbia, USA.
FAU - Reed, Mark
AU  - Reed M
AD  - Pulmonary, Critical Care, and Environmental Medicine, University of Missouri, 
      Columbia, USA.
FAU - Patel, Tarang
AU  - Patel T
AD  - Internal Medicine, University of Missouri Health Care, Columbia, USA.
LA  - eng
PT  - Case Reports
DEP - 20200520
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC7305576
OTO - NOTNLM
OT  - ga-68 dotatate scan
OT  - hyperparathyroidism
OT  - hypoglycemia
OT  - insulinoma
OT  - multiple endocrine neoplasia type 1
OT  - neuroendocrine tumor
OT  - octreotide scan
OT  - parathyroid gland adenoma
OT  - positive emission tomography
COIS- The authors have declared that no competing interests exist.
EDAT- 2020/06/25 06:00
MHDA- 2020/06/25 06:01
PMCR- 2020/05/20
CRDT- 2020/06/25 06:00
PHST- 2020/06/25 06:00 [entrez]
PHST- 2020/06/25 06:00 [pubmed]
PHST- 2020/06/25 06:01 [medline]
PHST- 2020/05/20 00:00 [pmc-release]
AID - 10.7759/cureus.8208 [doi]
PST - epublish
SO  - Cureus. 2020 May 20;12(5):e8208. doi: 10.7759/cureus.8208.