A Case of Insulinoma

Insulinoma 1례 보고

Insulinoma is the most frequent endocrine tumor of the pancreas and the first of the endocrine-secreting tumor of the gut to be recognized by Nicholls in 1902. Recurrent episodes of hypoglycemia is the main cause of the symptoms and signs which were sweating, pallor, dizziness, habitual change, convulsion and coma. In 1935, Whipple and Frants were described so-called "Whipple's triad" : the patient's symptoms occur with fasting or exercise; at the time of symptoms, the serum glucose in 50mg/dl or less; and the symptoms are relieved by the administration of glucose. While these criteria were timely, they proved to be rather nonspecific and may be found in other conditions that result in fasting hypoglycemia. We experienced a 44-year-old female patient who had repeated attacks of convulsion, unconsciousness and coma for 3 years. Although she has been treated with anticonvulsant, the symptoms and signs were not disappeared. At the time of administration, she was a full coma state due to hypoglycemia and was dramatically reversed by intravenous administration of the glucose solution. The preoperative test such as provocative test, abdominal CT and celiac angiography revealed insulinoma and after enucleation the pathologic diagnosis was the same. We like to report a adult female patient with insulinoma and the review of literatures briefly.

저자들은 경련성 발작후 의식소실이 자주 발생하였으며 그로 인해 항경련제를 장기간 투여하였고 저혈당으로 인한 의시소실의 상태로 내원한 비만한 여자 성인 환자에서 Insulinoma를 경험하였기에 문헌 고찰과 함께 보고하고자 한다.