A 35-year-old man presents with recurrent episodes of sweating, palpitations, tremor, and confusion relieved by eating. During a supervised 72-hour fast he develops neuroglycopenic symptoms with plasma glucose of 38 mg/dL and inappropriately elevated insulin and C-peptide levels. Which statement about his likely tumor is correct?
- A More than half are malignant at presentation
- B Serum chromogranin A is diagnostic
- C Approximately 90 percent are solitary, benign, and curable by enucleation when feasible ✓
- D They are equally distributed throughout the pancreas but never occur in ectopic sites
Correct answer: C. Approximately 90 percent are solitary, benign, and curable by enucleation when feasible
Explanation
Whipple's triad plus supervised fasting demonstrating endogenous hyperinsulinemic hypoglycemia establishes insulinoma. Around 90 percent are sporadic, solitary, benign adenomas less than 2 cm, and enucleation is curative when the duct relationship permits, so option C is correct. Gastrinomas, by contrast, are frequently malignant and multiple, making that comparison the trap.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.