Insulinoma-associated Transient Hypothalamus—Pituitary—Adrenal Axis Impairment and Amelioration by Steroid Therapy and Surgical Intervention: A Case Report

Insulinoma is the most common functional tumor among pancreatic islet cell tumors. This type of tumor is difficult to localize prior to surgery and can lead to serious hypoglycemia. This paper presents the case of a young female who suffered from insulinoma associated with transient hypothalamus—pituitary—adrenal axis impairment. To localize her insulinoma, we used two alternative testing methods, somatostatin receptor scintigraphy and selective arterial calcium stimulation with venous sampling, after a failure of conventional imaging methods. We treated her adrenal insufficiency and prevented serious hypoglycemia by giving her prednisolone. The impairment in her hypothalamus—pituitary—adrenal axis and her serious hypoglycemia recovered after excision of the tumor.

Key Words:  hypothalamus—pituitary—adrenal axis impairment , insulinoma

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