An unusual presentation of hypoglycemic distal polyneuropathy caused by an insulinoma in the context of multiple endocrine neoplasia 1

Authors

  • Oscar Castillo Sayán Servicio de Endocrinología, Hospital Nacional Arzobispo Loayza, Lima, Perú
  • Cecilia Medina Sánchez Servicio de Endocrinología, Hospital Nacional Arzobispo Loayza, Lima, Perú
  • Roger Verona Rubio Departamento de Patología, Hospital Nacional Arzobispo Loayza, Lima, Perú
  • Enrique Machicado Zuñiga Departamento de Cirugía, Hospital Nacional Arzobispo Loayza, Lima, Perú
  • German Mendoza Pérez Departamento de Medicina Nuclear, Instituto Peruano de Energía Nuclear, Lima,Perú
  • Lida Tello Cebreros Oficina de Epidemiología, Hospital Nacional Arzobispo Loayza, Lima,Perú

DOI:

https://doi.org/10.15381/anales.v79i4.15637

Keywords:

Multiple Endocrine Neoplasia Type 1, Hypoglycemia, Polyneuropathies, Insulinoma, Chordoma

Abstract

Multiple endocrine neoplasia type 1 is a rare disease. It is characterized by the neuroendocrine, parathyroid, pituitary, and enteropancreatic tumor involvement. We present the case of a 19 year old patient with symptoms of headache, convulsions and weakness of the four extremities. The presence of hypoglycemia 33mg/dL was confirmed. The electromyographic study showed motor sensory polyneuropathy in all four extremities. The abdominal magnetic resonance showed a tumor in the tail of the pancreas that after the pancreatectomy was confirmed as insulinoma. The glycemia was normalized. In addition, he presented a pituitary macroadenoma, primary hyperparathyroidism and non-functioning adrenal tumor. At 25 years of age, he presented severe headache and amaurosis of the right eye. Axial tomography showed a giant pituitary tumor and in the study of pathology chondroid malignancy (chordoma) was diagnosed.

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Published

2018-12-30

Issue

Vol. 79 No. 4 (2018)

Section

Reporte de Casos

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Copyright (c) 2018 Anales de la Facultad de Medicina

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How to Cite

1.
Castillo Sayán O, Medina Sánchez C, Verona Rubio R, Machicado Zuñiga E, Mendoza Pérez G, Tello Cebreros L. An unusual presentation of hypoglycemic distal polyneuropathy caused by an insulinoma in the context of multiple endocrine neoplasia 1. An Fac med [Internet]. 2018 Dec. 30 [cited 2024 Jul. 17];79(4):317-22. Available from: https://revistasinvestigacion.unmsm.edu.pe/index.php/anales/article/view/15637