Insulinoma, a rare pancreatic neuroendocrine tumor, stealthily lurks within the pancreas, often evading detection until its distinctive symptom, recurrent hypoglycemia, comes to the surface. This case report aims to highlight the significance of a multidisciplinary approach in the management of this uncommon neuroendocrine tumor by discussing the diagnostic, therapeutic, and follow-up difficulties encountered in an older adult presenting with atypical symptoms of insulinoma.

A 73-year-old lady presented with complaints of recurrent hypoglycemia. Her past medical history included Sjogren’s syndrome, arthritis, and immune thrombocytopenic purpura. She had a couple of episodes of falls with dizziness while in the shower over the year before starting to monitor her blood glucose levels. She had never been incontinent or had any episodes of seizures. She had been meticulously monitoring her blood glucose and reviewing her charts and was running low between 3 and 3.5 mmol/L. To combat this, she would eat to keep up with her blood glucose and, as a result, gained significant weight. No history of using any anti-diabetic medication. She would always carry dextrose tablets with her to avoid having low blood glucose and manage with fast-acting carbs.

Eram A. Mahaldar is an Internal Medicine professional based at the Nottingham University Hospitals National Health Service (NHS) Trust in Nottingham, GBR. He has contributed to academic literature, specifically focusing on rare pancreatic neuroendocrine tumors and their management.