Unique position of a pancreatic head insulinoma during laparoscopic enucleation: case report

Abdullah M. Alshamrani, Hisham M. Ghabbani, Omar M. Alobaid, Abdullah J. AlShehri, Khalid M. Alzaraa, Haider A. Alshurafa


Insulinomas are benign pancreatic neuroendocrine tumors that require surgical intervention as a therapeutic measure. We describe an 18-year-old male patient who presented to the emergency department with a history of syncope, blurred vision, and diaphoresis. His blood sugar level was low upon admission, and a 72-hour fasting plasma glucose test showed low serum glucose, high serum insulin, and high C-peptide. An abdominal computed tomography scan and magnetic resonant imaging revealed a solitary tumor in the pancreatic head with no sign of ductal dilatation. Laparoscopic enucleation was performed, and a histopathological examination revealed findings consistent with insulinoma. The patient’s postoperative course was uneventful, and his follow-up examination was unremarkable. In conclusion, physicians should have a high clinical suspicion index for insulinomas, especially in young patients with a history of syncope, blurred vision, and diaphoresis, in order to avoid delayed diagnosis.


Insulinoma, Laparoscopy, Pancreatic insulinoma

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