Giant 12 cm Pancreatic Insulinoma: Tumor Evolution, Management, and Pathologic Considerations.
7 affiliations
- 1Department of Surgery, Arrowhead Regional Medical Center, Colton, CA.
- 2Department of Surgery, Riverside University Health System Medical Center, Moreno Valley, CA.
- 3Kaiser Permanente Riverside Medical Center, Riverside, CA.
- 4Kaiser Permanente Fontana Medical Center, Riverside, CA.
- 5Department of Pathology, Kaiser Permanente Riverside Medical Center, Riverside, CA.
- 6Department of Surgery, Kaiser Permanente Riverside Medical Center, Riverside, CA.
- 7Department of Gastroenterology, Kaiser Permanente Fontana Medical Center, Fontana, CA.
Abstract
Insulinomas are characteristically small pancreatic neuroendocrine tumors, though giant variants have been reported. We describe a 63-year-old woman who presented with refractory hypoglycemia attributable to an exceptionally large 12 cm pancreatic mass that failed to respond to medical treatment. She was quickly taken for surgical resection, after which hypoglycemia quickly resolved. Histopathologic examination demonstrated a well-differentiated pT3N0 neuroendocrine tumor demonstrating negative staining for insulin and pancreatic and duodenal homeobox 1, with positive staining for insulinoma-associated protein 1, alpha-thalassemia/mental retardation X-linked, and alpha-1-antitrypsin. Repeat imaging showed no tumor recurrence. This case illustrates an uncommon presentation and highlights key immunostains in delineating different insulinoma phenotypes.
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BibTeX
@article{hormozian2026giant,
title = {{Giant 12 cm Pancreatic Insulinoma: Tumor Evolution, Management, and Pathologic Considerations.}},
author = {Sean Hormozian and Yasmin Gore and Therence Kotafoya and Andrew Zhang and Mehran Taherian and Albert Ko and Zhigang Song},
journal = {ACG case reports journal},
year = {2026},
month = oct,
doi = {10.14309/crj.0000000000002364},
url = {https://europepmc.org/article/MED/42953898},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Giant 12 cm Pancreatic Insulinoma: Tumor Evolution, Management, and Pathologic Considerations.
AU - Sean Hormozian
AU - Yasmin Gore
AU - Therence Kotafoya
AU - Andrew Zhang
AU - Mehran Taherian
AU - Albert Ko
AU - Zhigang Song
PY - 2026
DA - 2026/10/28
JO - ACG case reports journal
DO - 10.14309/crj.0000000000002364
UR - https://europepmc.org/article/MED/42953898
AB - Insulinomas are characteristically small pancreatic neuroendocrine tumors, though giant variants have been reported. We describe a 63-year-old woman who presented with refractory hypoglycemia attributable to an exceptionally large 12 cm pancreatic mass that failed to respond to medical treatment. She was quickly taken for surgical resection, after which hypoglycemia quickly resolved. Histopathologic examination demonstrated a well-differentiated pT3N0 neuroendocrine tumor demonstrating negative staining for insulin and pancreatic and duodenal homeobox 1, with positive staining for insulinoma-associated protein 1, alpha-thalassemia/mental retardation X-linked, and alpha-1-antitrypsin. Repeat imaging showed no tumor recurrence. This case illustrates an uncommon presentation and highlights key immunostains in delineating different insulinoma phenotypes.
SN - 2326-3253
ER -