Sandbox parminder

*Endocrine cells in insulinoma are organised in nests and trabecular pattern scattered throughout a fibro-vascular stroma with well-localised fibrous septa separating it from normal tissue

• Absence of exocrine tissue with the loss of normal pancreatic architecture

Patients with insulinomas usually develop neuroglycopenic symptoms. These include recurrent headache, lethargy, diplopia, and blurred vision, particularly with exercise or fasting. Severe hypoglycemia may result in seizures, coma, and permanent neurological damage. Symptoms resulting from the catecholaminergic response to hypoglycemia (i.e. tremulousness, palpitations, tachycardia, sweating, hunger, anxiety, nausea) are not as common. Sudden weight gain (the patient can become massively obese) is sometimes seen. A neater list of symptoms would include:

• Anxiety
• Behavior changes
• Blurred vision
• Confusion
• Convulsions
• Dizziness
• Headache
• Hunger
• Loss of consciousness
• Rapid heart rate
• Sweating
• Tremor
• Weight gain