Biochemical And Clinical Features Of Insulinoma In Turner Syndrome

History: A 53-year-old woman with small stature and dysmorphic features consistent with Turner syndrome (TS), and not previously diagnosed with Diabetes approached an endocrinology clinic for evaluation of episodes of hypoglycemia <20mg/dl with transient loss of consciousness. Consequently, the patient was admitted to the inpatient services and underwent a controlled 72h fast. After 64h, she developed hypoglycemia (30s mg/dl) with mild neuroglycopenic symptoms (emotional outbursts). Clinical Examination Results: Insulin levels (1.2mIU/L) Elevated proinsulin (30 pmol/L) The beta-hydroxybutyrate level at 6500umol/L.

Image-Based Findings: MR and multiphase CT [Figure 1] showed a solid, hyper enhancing 2.5cm pancreatic tail mass with slow washout. Octreoscan [Figure 2] demonstrated the absence of radiotracer uptake ruling out a splenule. CT guided fine needle biopsy of the mass confirmed…