Intermittent disturbances of perception during fasting in a 46-year-old female patient
We report the case of a 46-year-old female patient who presented in the emergency department with intermittent disturbances of perception when fasting. In the diagnostic fasting test, a hyperinsulinemic hypoglycemia already occurred after 7h. A sonographic examination was inconspicuous, therefore, a Ga 68-HA-DOTATATE positron emission tomography computed tomography (PET-CT) was carried out. The results were indicative of a neuroendocrine neoplasm, which gave rise to the suspicion of an insulinoma. For surgical treatment the patient was transferred to an external hospital. Following surgery, the patient was free of symptoms. If multiple symptoms of hypoglycemia are present, an insulinoma as the cause must be considered in the differential diagnostics.