Insulinoma Identified in Puerperium: Association with Pregnancy and Literature Review

Authors

• Rossana Orabona Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Obstetrics and Gynecology, ASST Spedali Civili, Brescia, Italy
• Cristina Zanardini Obstetrics and Gynecology, ASST Spedali Civili, Brescia, Italy
• Andrea Lojacono Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Obstetrics and Gynecology, ASST Spedali Civili, Brescia, Italy
• Sonia Zatti Obstetrics and Gynecology, ASST Spedali Civili, Brescia, Italy
• Carlo Cappelli Department of Clinical and Experimental Sciences, Endocrine and Metabolic Unit, Medical Clinic, University of Brescia, Brescia, Italy
• Guido AM Tiberio Department of Molecular and Translational Medicine, ASST Spedali Civili, Third Division of General Surgery, University of Brescia, Italy
• Vincenzo Villanacci Institute of Pathology, ASST Spedali Civili, Brescia, Italy
• Enrico Sartori Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Obstetrics and Gynecology, ASST Spedali Civili, Brescia, Italy

rossana.orabona@gmail.com

Keywords

Abstract

Postpartum hypoglycemia in non-diabetic women is a rare condition. We report the case of a 34-year-old woman who experienced neuroglycopenia 2 days after delivery. Corresponding to severe hypoglycemia, we found inappropriately elevated insulin and C-peptide levels. Following magnetic resonance imaging a lesion of 10x8 mm was detected in the head of the pancreas. An ultrasound-guided fine needle aspiration of the mass confirmed the diagnostic suspicion of a pancreatic neuroendocrine tumor. Complete surgical enucleation of the insulinoma resulted in immediate and permanent resolution of the hypoglycemia. The postoperative course was uneventful. Histopathological and immunohistochemical analyses were consistent with insulinoma. The diagnostic approach to postpartum hypoglycemia represents a challenge for multidisciplinary teamwork.