{"title":"Recurrence of malignant insulinoma in the context of multiple endocrine neoplasia type 1: a case report.","authors":"Marcela Palomo, Ximena Rivera, Isabella Santamarina","doi":"10.1093/jscr/rjaf335","DOIUrl":null,"url":null,"abstract":"<p><p>Insulinomas are rare pancreatic neuroendocrine tumors, typically benign, but in the context of multiple endocrine neoplasia type 1 (MEN1), they can be malignant and recurrent. This case report presents a 58-year-old man with MEN1 who initially underwent partial pancreatectomy for a malignant insulinoma in the pancreatic tail in 2019. Despite recurrence in 2021, the patient declined surgery; however, in 2025, he presented with hypoglycemia and imaging revealed a 3-cm mass in the pancreatic head. He underwent a Whipple procedure, with histopathological analysis confirming the recurrent insulinoma. This case highlights the clinical challenge of managing malignant insulinomas in MEN1, emphasizing the importance of long-term follow-up and staged surgical interventions due to the high risk of recurrence.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2025 5","pages":"rjaf335"},"PeriodicalIF":0.4000,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095995/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/jscr/rjaf335","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
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Abstract
Insulinomas are rare pancreatic neuroendocrine tumors, typically benign, but in the context of multiple endocrine neoplasia type 1 (MEN1), they can be malignant and recurrent. This case report presents a 58-year-old man with MEN1 who initially underwent partial pancreatectomy for a malignant insulinoma in the pancreatic tail in 2019. Despite recurrence in 2021, the patient declined surgery; however, in 2025, he presented with hypoglycemia and imaging revealed a 3-cm mass in the pancreatic head. He underwent a Whipple procedure, with histopathological analysis confirming the recurrent insulinoma. This case highlights the clinical challenge of managing malignant insulinomas in MEN1, emphasizing the importance of long-term follow-up and staged surgical interventions due to the high risk of recurrence.
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