Keywords
, hipoglucemia
insulinoma
How to Cite
Abstract
Presentamos una mujer de 42 años quien consultó por parestesia lingual y ganancia de 10 Kg de peso, sin síntomas clásicos de hipoglucemia, a quién se le encontró una glucemia en ayunas de 46 mg/dl (2,6 mmol/L) con insulina y péptido C concomitantes de 10,2 µU/ml (73,2 pmol/L) y 2,14 ng/dl (79,2 nmol/L) respectivamente. Hallazgos similares fueron encontrados en una segunda ocasión. La resonancia magnética del páncreas mostró una lesión de 1,7 x 1,3 cm dependiente del reborde superior del cuerpo, la cual fue extirpada vía laparoscopia. Patología reveló un tumor neuroendocrino con inmunohistoquímica positiva para insulina, cromogranina y sinaptofisina. La parestesia lingual desapareció y la glucosa se normalizó. La tríada de Whipple no siempre está presente en pacientes con hipoglucemia, mientras que la parestesia lingual debe considerarse para la evaluación de estos pacientes.
Abstract
We report on a 42 years old female who consulted because of lingual paresthesia and 10 kg weight gain but without classic symptoms of hypoglycemia, who had a fasting blood glucose of 46 mg/dl (2.6 mmol/L) with a concomitant insulin a C-peptide of 10.2 µU/ml (73.2 pmol/L) and 2.14 ng/dl (79.2 nmol/L) respectively. Similar findings were obtained on a second occasion. Magnetic resonance of the pancreas revealed a 1.7 x 1.3 cm lesion dependent of the superior border of the body which was removed by laparoscopy.
Pathology showed a neuroendocrine tumor with positive immmunohistochemistry for insulin, chromogranin and synaptophysin. Lingual paresthesia disappeared and blood glucose was normalized. Patients with lingual paresthesia should be evaluated for hypoglycemia even in the absent of a classic Whipple triad.
References
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