Sandbox: DDx 2

Differential Diagnosis	Key Symptoms	Characteristic Lab Findings	CT Scan	Characteristic Histopathological Features
Insulinoma	Diaphoresis Tremor Palpitations Seizures Coma	Hypoglycemia Hyperinsulinemia Elevated C-peptide level Elevated Pro-insulin level	Calcification and hyperattenuation of the mass	Solid or gyriform cellular patterns Amyloid deposition Nesidioblastosis may be present Absence of glands
VIPoma	Watery diarrhea Dehydration Lethargy Muscle weakness Flushing	Elevated (VIP) levels Elevated neurotensin levels Hypokalemia Hypomagnesaemia Hypercalcaemia Metabolic acidosis	Hypervascularity with diffuse multiple metastatic nodulation	Solid sheets Uniform cuboidal cells Centrally located nuclei Stippled chromatin Granular eosinophilic cytoplasm
Tumor stage	M0 stage confirmed by MRI and CSF sampling	M1-M3 stage or presence of leptomeningeal seeding	M0 stage confirmed by MRI and CSF sampling	M1-M3 stage or presence of leptomeningeal seeding

• Solid or gyriform cellular patterns
• Amyloid deposition
• Nesidioblastosis may be present
• Absence of glands