case_images: PMC9355856_01
case_images: Baseline and post-RFA ambulatory glucose profile. isCGM, intermittently scanned continuous glucose monitoring; RFA, radiofrequency ablation; CGM, continuous glucose monitoring.
case_images: fendo-13-957369-g001.jpg
case_images: PMC9355856_01_fendo-13-957369-g001.jpg
case_images: f1
case_images: However, he also had significant postprandial glucose excursions with readings reaching above 13.0mmol/L after meals. ( Figure 1 ) Overall, only 42% of time was within the pre-set glucose range between 4.5 mmol/L and 8.0 mmol/L, while 41% and 17% of the time his glucose readings were above and below target, respectively.
case_images: PETCT scan of the patient showing a tumour in the pancreatic head with vague DOTATATE avidity (red arrows) but without FDG or F-DOPA avidity. FDG, 18F-fluorodeoxyglucose; F-DOPA, 18F-fluorolevodopa (F-DOPA); PETCT, positron emission tomography-computed tomography.
case_images: fendo-13-957369-g002.jpg
case_images: PMC9355856_01_fendo-13-957369-g002.jpg
case_images: f2
case_images: Endoscopic ultrasound images of the patient before, during and after RFA. RFA, radiofrequency ablation.
case_images: fendo-13-957369-g003.jpg
case_images: PMC9355856_01_fendo-13-957369-g003.jpg
case_images: f3
case_images: Effective ablation was achieved with intralesional hyperechoic signal noted after the procedure. ( Figure 3 ) Fine needle biopsy (FNB) was also performed before RFA using a 19G Procore needle.
case_images: Contrast CT scan of the patient at baseline and 18 months after RFA. CT, computed tomography; RFA, radiofrequency ablation.
case_images: fendo-13-957369-g004.jpg
case_images: PMC9355856_01_fendo-13-957369-g004.jpg
case_images: f4
case_images: A reassessment contrast CT abdomen performed after 18 months showed complete resolution of the previously noted pancreatic head lesion. ( Figure 4 ) Together with the fact that the patient remained insulin-requiring without significant hypoglycaemic attacks, complete cure of the insulinoma is achieved.