{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:59:53Z","timestamp":1791489593059,"version":"4.3.4"},"reference-count":29,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We report a case of a 35\u2013year-old woman with recurrent episodes of hypoglycemia. Biochemical investigation was suggestive of hyperinsulinemic hypoglycemia, and hence a provisional diagnosis of insulinoma was made. Despite extensive investigation using magnetic resonance imaging, endoscopic ultrasound, and 68Ga-DOTATATE positron emission tomography\/computed tomography (PET\/CT) scanning, the tumor could not be localized. Long-distance travel allowed her to undergo a 68Ga-Exendin-4 PET\/CT scan that identified a lesion in the uncinate process of the pancreas, subsequently confirmed by intraoperative ultrasound. Enucleation of the 1.5-cm lesion was performed, and histopathology confirmed a well-differentiated pancreatic neuroendocrine tumor. Postoperatively, the patient has remained free of hypoglycemic episodes and has shown normalization of glucose levels. This case underscores the efficacy of 68Ga-Exendin-4 PET\/CT in the localization of an occult insulinoma, facilitating timely and curative surgical intervention, and the importance of patients having access to such a facility when not locally available.<\/jats:p>","DOI":"10.1210\/jcemcr\/luae192","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T15:41:44Z","timestamp":1729870904000},"source":"Crossref","is-referenced-by-count":5,"title":["A Long Way to Find a Small Tumor: The Hunt for an Insulinoma"],"prefix":"10.1210","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5110-334X","authenticated-orcid":false,"given":"Durairaj","family":"Arjunan","sequence":"first","affiliation":[{"name":"Department of Endocrinology, PGIMER , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1176-6186","authenticated-orcid":false,"given":"Ashley B","family":"Grossman","sequence":"additional","affiliation":[{"name":"Green Templeton College, University of Oxford , Oxford OX26HG ,","place":["UK"]},{"name":"ENETS Centre of Excellence, Royal Free Hospital , London NW32QG ,","place":["UK"]},{"name":"Barts and the London School of Medicine, Queen Mary University of London , London E14NS ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1472-104X","authenticated-orcid":false,"given":"Harmandeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, PGIMER , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3938-6241","authenticated-orcid":false,"given":"Rakesh","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of HPB surgery and trasplantation, King's College Hospital , Dubai, UAE"},{"name":"Gulf Medical University , Sharjah 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