{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:49:12Z","timestamp":1791452952352,"version":"4.3.3"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":280,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004770","name":"Universit\u00e0 degli Studi di Parma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004770","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Endocrinology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Localization of recurrent or residual insulinoma may be particularly challenging in postoperative setting, especially in the presence of postoperative anatomical distortion and inconclusive conventional imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>\n                      A 71\u2010year\u2010old man developed recurrent endogenous hyperinsulinemic hypoglycemia following apparently curative surgical enucleation of a pancreatic insulinoma. The postoperative course was complicated by intra\u2010abdominal hemorrhage and pseudocyst formation, resulting in marked anatomical distortion. Despite persistent biochemical evidence of insulinoma recurrence, serial contrast\u2013enhanced computed tomography (CT) and\n                      <jats:sup>68<\/jats:sup>\n                      Ga\u2010DOTATOC PET\/CT failed to identify residual disease. Subsequent glucagon\u2010like peptide\u20101 receptor (GLP\u20101R) imaging with\n                      <jats:sup>68<\/jats:sup>\n                      Ga\u2010NODAGA\u2010Exendin\u20104\u2009PET\/CT demonstrated focal tracer uptake in the pancreatic head, highly suggestive of recurrent or residual insulinoma. Endoscopic ultrasound (EUS) subsequently confirmed a small lesion in the uncinate process, which was successfully treated with EUS\u2013guided radiofrequency ablation (EUS\u2010RFA). Following the procedure, hypoglycemic episodes resolved, with normalization of glucose, insulin, and C\u2010peptide levels and no signs of recurrence at follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the clinical value of GLP\u20101 receptor PET\/CT for localizing insulinoma in the context of negative conventional or somatostatin receptor (SSTR)\u2013based imaging. Accurate functional localization may directly guide minimally invasive therapeutic interventions and help avoid high\u2010risk reoperative pancreatic surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crie\/7874466","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:51:00Z","timestamp":1791449460000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent Hyperinsulinemic Hypoglycemia After Insulinoma Surgery: Diagnostic Impact of GLP\u20101 Receptor PET\/CT After Negative Conventional Imaging"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8027-4520","authenticated-orcid":false,"given":"Lorenzo","family":"Taglia","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery University of Parma  Parma Italy  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