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Case report of a pancreatic insulinoma misdiagnosed as epilepsy
  1. Barbara Anna Williams1,
  2. Simon Lampart1,
  3. Jürg Metzger2 and
  4. Stefan Fischli3
  1. 1Department of Internal Medicine, Luzerner Kantonsspital, Luzern, Switzerland
  2. 2Departement of Viceral Surgery, Luzerner Kantonsspital, Luzern, Switzerland
  3. 3Division of Endocrinology, Diabetes and Clinical Nutrition, Luzerner Kantonsspital, Luzern, Switzerland
  1. Correspondence to Dr Stefan Fischli; stefan.fischli{at}


A 55-year-old patient had spent 12 years with unexplained seizures, initially diagnosed as epilepsy and then as a psychiatric disorder. When she was admitted with hypoglycaemia, a fasting test was performed showing blood sugar levels as low as 1 mmol/L with symptoms of neuroglycopenia. Insulinoma was suspected and an MRI showed a large tumour in the tail region of the pancreas. A Dodecanetetraacetic acid-Tyr3-octreotate (DOTATATE) positron emission tomography CT indicated no malignancy and showed no signs of metastasis. The patient underwent surgery, leaving her asymptomatic.

  • endocrinology
  • endocrine cancer
  • general surgery
  • epilepsy and seizures

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  • Contributors BAW interviewed the patient and wrote the case report, SF and SL revised the case report, and JM provided intraoperative images of the insulinoma.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.