<unk>  is the tumor of β islet cells of pancreas involved in the production of insulin. They are rare tumors and the incidence varies from 0.1 to 0.4 per 100,000. It commonly affects females in the age group of 40-60 years. It is associated with diseases such as MEN1, Von Hippel-Lindau, and Neurofibromatosis. The overproduction of insulin causes hypoglycemia and manifests as neuroglycopenic symptoms such as altered mental status, confusion, coma and adrenergic symptoms such as profuse sweating, tremors and palpitations. There are no physical exam findings usually. It is suspected by the presence of Whipple's triad which is serum glucose < 55mg/dL, features/symptoms of hypoglycemia as described above and resolution of symptoms with administration of glucose. The gold standard for diagnosis is 72-hour fasting and the laboratory findings include serum glucose < 55 mg/dL . Insulin > 5-10 μU/mL, S. C-Peptide >200 pmol/L, S. proinsulin ≥ 22 pmol/L. CT scan is the first line of investigation. The highest sensitivity is seen in dual-phase helical CT with thin slices up to 94.4%. MRI is the second line of investigation. Trans-abdominal ultrasound and X-ray have less sensitivity in detecting<unk> . Invasive modalities like endoscopic ultrasound are adopted if CT and MRI are inconclusive. Other diagnostic modalities include PET scan, intra-operative ultrasound and arterial calcium stimulation with hepatic vein sampling (ASVS).
Insulinoma
Glucagonoma
Congenital hyperinsulinism
ACTH-secreting tumor
Idiopathic hypoglycemia
Adie syndrome
Pituitary adenoma
Hyperinsulinism