Insulinoma is the most common islet cell tumor of the pancreas. Unlike other functional endocrine tumors, insulinomas can be found throughout the pancreatic parenchyma. Characteristic findings of insulinoma are fasting hypoglycemia, symptoms of hypoglycemia, and relief of hypoglycemia with carbohydrate (ie, Whipple triad). The Whipple procedure is not indicated for small masses in the tail of the pancreas. Distal pancreatectomy would be a correct response if the patient had a larger tumor (> 2 cm). This patient has a small tumor (< 2 cm) and therefore enucleation can be performed to remove it. Observation is not appropriate in this setting.
1. Cameron JL, editor. Current surgical therapy. 8th ed. Philadelphia: Elsevier Mosby; 2004.
2. Townsend CM, Beauchamp RD, Evers BM, et al. Sabiston textbook of surgery: the biological basis of modern surgical practice. 17th ed. Philadelphia: Saunders; 2004.
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