A 24-year-old woman with hyperinsulinemic hypoglycemia was found with a pancreatic mass and multiple intrahepatic lesions in CT and MRI. 68Ga-exendin-4 PET/CT showed intense radioactivity in the pancreatic mass and all the intrahepatic lesions, suggesting a malignant insulinoma with multiple intrahepatic metastases. Subsequent fine needle biopsy confirmed the diagnosis of WHO grade 3 insulinoma. This case with extensive glucagon-like peptide-1 receptor (GLP-1R) expression in a high-grade malignant insulinoma highlighted the potential of GLP-1R-targeted PRRT in future clinical studies.
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A 24-year-old woman with hyperinsulinemic hypoglycemia was found with a pancreatic mass and multiple intrahepatic lesions in CT and MRI. 68Ga-exendin-4 PET/CT showed intense radioactivity in the pancreatic mass and all the intrahepatic lesions, suggesting a malignant insulinoma with multiple intrahepatic metastases. Subsequent fine needle biopsy confirmed the diagnosis of WHO grade 3 insulinoma.
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