Endoscopic ultrasound-guided radiofrequency ablation for a pancreatic insulinoma: a novel endoscopic management strategy

Although rare, insulinomas are the most common functional pancreatic neuroendocrine tumors (NETs), typically presenting with Whipple's triad – symptoms of hypoglycemia, low plasma glucose, and symptom resolution after glucose administration [1]. While surgery remains the primary curative treatment for an insulinoma, its potential for significant adverse outcomes has prompted exploration of less invasive approaches, such as endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) [2] [3]. EUS-RFA has shown high efficacy and a favorable safety profile in the treatment of insulinomas, especially for patients who are not suitable for surgery [4]. The purpose of presenting this case is to highlight the role of EUS-RFA as a minimally invasive and effective treatment option for an insulinoma in a patient who declined to undergo surgery ([Video 1]).