Insulinoma Identified in Puerperium: Association with Pregnancy and Literature Review.
Neuroendocrine tumor
hypoglycemia
insulinoma
neuroglycopenia
postpartum
pregnancy
puerperium
Journal
European journal of case reports in internal medicine
ISSN: 2284-2594
Titre abrégé: Eur J Case Rep Intern Med
Pays: Italy
ID NLM: 101648453
Informations de publication
Date de publication:
2020
2020
Historique:
received:
05
02
2020
accepted:
11
02
2020
entrez:
21
4
2020
pubmed:
21
4
2020
medline:
21
4
2020
Statut:
epublish
Résumé
Postpartum hypoglycemia in non-diabetic women is a rare condition. We report the case of a 34-year-old woman who experienced neuroglycopenia 2 days after delivery. Corresponding to severe hypoglycemia, we found inappropriately elevated insulin and C-peptide levels. Following magnetic resonance imaging a lesion of 10×8 mm was detected in the head of the pancreas. An ultrasound-guided fine needle aspiration of the mass confirmed the diagnostic suspicion of a pancreatic neuroendocrine tumor. Complete surgical enucleation of the insulinoma resulted in immediate and permanent resolution of the hypoglycemia. The postoperative course was uneventful. Histopathological and immunohistochemical analyses were consistent with insulinoma. The diagnostic approach to postpartum hypoglycemia represents a challenge for multidisciplinary teamwork. Although insulinomas are extremely rare during pregnancy, most cases are recognized or become symptomatic during the first trimester.Symptoms of insulinomas may be initially masked due to changes in glucose metabolism and insulin resistance associated with pregnancy.In pregnancy, surgical treatment should be avoided whenever possible because of the risks to both mother and fetus; conservative treatment, including dietary intake, intravenous glucose and glucagon, should be initiated to control the hypoglycemia symptoms.
Identifiants
pubmed: 32309265
doi: 10.12890/2020_001556
pii: 1556-1-12250-1-10-20200310
pmc: PMC7162563
doi:
Types de publication
Journal Article
Langues
eng
Pagination
001556Informations de copyright
© EFIM 2020.
Déclaration de conflit d'intérêts
Conflicts of Interests: The Authors declare that there are no competing interests.
Références
Curr Opin Gastroenterol. 2011 Sep;27(5):475-80
pubmed: 21743318
Fertil Steril. 2008 Jul;90(1):199.e1-4
pubmed: 17980876
Baillieres Clin Endocrinol Metab. 1993 Jul;7(3):731-9
pubmed: 8379913
Mayo Clin Proc. 1991 Jul;66(7):711-9
pubmed: 1677058
Pancreas. 2014 Jul;43(5):675-86
pubmed: 24921202
J Clin Endocrinol Metab. 1988 Aug;67(2):341-7
pubmed: 3292560
Diabetes. 2002 Jul;51(7):2207-13
pubmed: 12086951
World J Gastroenterol. 2013 Feb 14;19(6):829-37
pubmed: 23430217
Arq Gastroenterol. 2003 Apr-Jun;40(2):73-9
pubmed: 14762475
J Clin Endocrinol Metab. 2000 Sep;85(9):3222-6
pubmed: 10999812
JOP. 2014 Jan 10;15(1):53-7
pubmed: 24413786
Ann Surg. 1935 Jun;101(6):1299-335
pubmed: 17856569
Endocrinol Metab Clin North Am. 2017 Sep;46(3):761-781
pubmed: 28760237
Int J Surg Case Rep. 2019;61:119-122
pubmed: 31357102
Medicine (Baltimore). 2016 Mar;95(11):e3045
pubmed: 26986124
Fertil Steril. 2009 Feb;91(2):656
pubmed: 19111295