Case Report: RARE CASE OF INSULINOMA

Insulinoma is a rare functioning pancreatic neuroendocrine tumor (PNET) originating from the beta cells of the islets of Langerhans and characterized by unregulated insulin secretion. Most insulinomas are benign and solitary, but their clinical manifestations are often nonspecific and primarily result from hypoglycemia, which can be easily misdiagnosed as neurological disorders such as epilepsy or psychiatric conditions. Early diagnosis of insulinoma remains a clinical challenge due to its atypical presentation and the frequent failure to assess blood glucose at symptom onset. A case of a 32-year-old Vietnamese female admitted to a provincial hospital for recurrent neurological symptoms, including loss of consciousness, seizures, and incoherent speech, who had been treated for refractory epilepsy for over two years without improvement. Biochemical investigations revealed inappropriately elevated serum insulin levels and concomitant hypoglycemia. Abdominal imaging with computed tomography (CT) identified a pancreatic tail mass suggestive of insulinoma. The patient underwent laparoscopic distal pancreatectomy. Histopathology confirmed an isodense carcinoma consistent with grade 2 insulinoma. This case highlights the importance of considering insulinoma in patients with unexplained neurological symptoms and poor response to antiepileptic therapy.