Heterogeneity of multiple pancreatic neuroendocrine tumors identified by 68Ga-DOTANOC and 68Ga-exendin-4 PET/CT in a patient with endogenous hyperinsulinemic hypoglycaemia and multiple endocrine neoplasia 1

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Introduction: Insulinomas are the most frequent functional neuroendocrine tumors of pancreas cause endogenous hyperinsulinemic hypoglycemia (EHH). In about 10% cases, insulinomas are associated with multiple endocrine neoplasia 1 (MEN1).

Aim(s): Herein, we present a case of 44-year-old female with recurrent hypoglycemia and MEN1 mutation.

Materials and methods: From 2021, hypoglycemic appeared frequently. In June 2023, enhanced CT showed multiple pancreatic lesions abundant with blood supply. Fasting blood glucose and serum insulin were 1.73mmol/L and 15.2U/L. Germline genes suggested MEN1 pathogenic mutations. 68Ga-DOTANOC PET/CT indicated there were multiple lesions located in the pancreas and duodenum with high expression of somatostatin receptor (SSTR). Due to functional NET, 68Ga-exendin-4 PET/CT were added to localize the insulinoma.

Conference:

Presenting Author: Xu J

Authors: Xu X, Xu X, Liang Y, Zhang M, Chen J,

Keywords: MEN1, insulinoma, 68Ga-DOTANOC, 68Ga-exendin-4, PET/CT,