A Case of Insulinoma in a Patient with Neurofibromatosis Type 1

Abstract

A 37-year-old man was presented with seizures and loss of consciousness. Morning hypoglycemia was observed, and since contrast-enhanced computed tomography showed a clearly demarcated, hypervascular tumor in the pancreatic head and boby, insulinoma was diagnosed. Surgery was scheduled, but because the patient also had neurofibromatosis type 1, there were multiple other nodules in the pancreas, and these had to be distinguished intraoperatively to enable total resection of the insulinoma. Partial pancreatectomy was conducted with the use of preoperative selective arterial calcium injection, intraoperative ultrasound, rapid intraoperative pathological diagnosis, and intraoperative blood insulin measurement during rapid calcium infusion. Three years postoperatively, there has been no sign of recurrence.