Insulinoma: A commonly misdiagnosed pancreatic tumour

Insulinomas are rare tumors of the neuroendocrine variety. Importantly, insulinomas are seldom malignant; if metastatic disease is not found at the time of initial diagnosis, it is unlikely to develop in the future (albeit rare metachronous metastases and local recurrence at the surgical site have been reported). Symptoms due to excessive insulin secretion can mimic psychoses and misdiagnosis is common. We report the case of a twenty five year old man who was treated for four years as a case of psychosis. It was only when one of the physicians got a fasting blood sugar level done that the diagnosis of insulinoma was suspected. He had a three centimeter tumour in the uncinate process which was enucleated and the patient was cured. Thus, accurate diagnosis is essential for this potentially curable condition.