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Insulinoma is a rare pancreatic neuroendocrine tumor with an incidence of 4 per million. Ectopic insulinomas are even rarer and comprise 1-2% of these cases. In cases which have established endogenous hyperinsulinemic hypoglycemia, a high-index of suspicion must be maintained since conventional tests like Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) may miss these tumors. Endoscopic ultrasound can be utilised in localisation as it is more sensitive and specific compared to CT or MRI with an added applicability in obtaining a biopsy. However, operator skill and experience play a crucial role in identifying extra-pancreatic insulinomas.
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SA et al. (2023) studied this question.
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