{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:29:31Z","timestamp":1787923771992,"version":"build-2784847793"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Insulinoma is a rare neuroendocrine tumor characterized by episodes of hypoglycemia. Peripheral neuropathy associated with hypoglycemia is an uncommon complication of insulinoma, and its reversibility remains a subject of debate within the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>We describe the case of a 22-year-old female patient diagnosed with a solitary pancreatic insulinoma. The patient experienced recurrent episodes of headache, blurred vision as well as numbness, tingling and burning pain of the limbs over a period of 6 to 12 months prior to definitive diagnosis. Electrophysiological investigations revealed findings consistent with multiple radiculopathies and a motor-predominant axonal sensorimotor polyneuropathy primarily affecting the upper limbs. The biochemical diagnosis of endogenous hyperinsulinemic hypoglycemia was confirmed through a supervised standard 72-hour fasting test. Abdominal computed tomography imaging identified a contrast-enhancing tumor at the pancreatic body-tail transition. The patient underwent a laparoscopic distal pancreatectomy with splenectomy. Postoperative follow-up revealed prompt resolution of hypoglycemia, alongside improvement in dysesthesia and sensory deficit in the extremities as well as most neurophysiological parameters. However, tendon reflexes remained diminished, and subtle distal-predominant lower limb weakness and gait imbalance persisted for several months postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case underscores the importance of recognizing a rare neural complication associated with insulinoma. The incomplete resolution of neurological symptoms and neurophysiological abnormalities highlights the potentially lasting impact of recurrent severe hypoglycemia on peripheral neural function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1924634","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:52:50Z","timestamp":1787921570000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Is hypoglycemic polyneuropathy reversible after curative resection of an insulinoma? A case report and literature review"],"prefix":"10.3389","volume":"17","author":[{"given":"Anna","family":"K\u00f6rei","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Gombos","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ny\u00edr\u0151 Gyula National Institute of Psychiatry and Addictions","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katalin","family":"Borka","sequence":"additional","affiliation":[{"name":"Department of Pathology, Forensic and Insurance Medicine, Faculty of Medicine, Semmelweis University","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kempler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"T\u0151ke","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikl\u00f3s","family":"T\u00f3th","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.657","article-title":"Occult sporadic insulinoma: localization and surgical strategy","volume":"14","author":"Abboud","year":"2008","journal-title":"World J Gastroenterol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1136\/gutjnl-2011-300831","article-title":"Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs)","volume":"61","author":"Ramage","year":"2012","journal-title":"Gut"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s004010100459","article-title":"Hypoglycemic neuropathy","volume":"102","author":"Mohseni","year":"2001","journal-title":"Acta Neuropathol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.60.707.577","article-title":"Neurological aspects of insulinomas","volume":"707","author":"Daggett","year":"1984","journal-title":"Postgrad Med J"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4598(200012)23:12<1891::aid-mus17>3.0.co;2-y","article-title":"Hypoglycemic sensorimotor polyneuropathy associated with insulinoma","volume":"23","author":"Heckmann","year":"2000","journal-title":"Muscle Nerve"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2011.11.015","article-title":"Multiple endocrine neoplasia type 1 presenting as refractory epilepsy and polyneuropathy--a case report","volume":"315","author":"de Paiva","year":"2012","journal-title":"J Neurol Sci"},{"key":"B7","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1002\/mdc3.12123","article-title":"Paroxysmal dystonia with axonal neuropathy resulting from benignant insulinoma: case report","volume":"2","author":"Pozzi","year":"2015","journal-title":"Mov Disord Clin Pract"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2023.108603","article-title":"Pancreatic insulinoma: diagnosis and treatment of a rare tumour with misleading symptoms - a case report","volume":"109","author":"Agbozo","year":"2023","journal-title":"Int J Surg Case Rep"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/reports8030175","article-title":"Diagnosis and surgical management of pancreatic insulinoma in a non-diabetic patient: a case report","volume":"8","author":"Montenegro","year":"2025","journal-title":"Rep (MDPI)"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.4532","article-title":"Impaired glucose tolerance with neurological manifestations in insulinoma","volume":"12","author":"Villanueva-Rodr\u00edguez","year":"2021","journal-title":"Clin Case Rep"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.71931","article-title":"Insulinoma in a young patient with focal seizures: a case report of a neurological diagnostic challenge","volume":"14","author":"Valerio L\u00f3pez","year":"2026","journal-title":"Clin Case Rep"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics15030337","article-title":"Pancreatic neuroendocrine tumors-diagnostic pitfalls of non-diabetic severe hypoglycemia: literature review and case report","volume":"15","author":"Popa","year":"2025","journal-title":"Diagnostics (Basel)"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1177\/23247096211051927","article-title":"Sensorimotor polyneuropathy in a diabetic patient after rapid overcorrection of chronic hyperglycemia","volume":"9","author":"Broadhead","year":"2021","journal-title":"J Investig Med High Impact Case Rep"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1969.00480140021002","article-title":"Hypoglycemic peripheral neuropathy","volume":"21","author":"Danta","year":"1969","journal-title":"Arch Neurol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2011.10.018","article-title":"An unusual cause of reversible axonal neuropathy and hypertension in a 10-year-old girl","volume":"19","author":"Kaul","year":"2012","journal-title":"J Clin Neurosci"},{"key":"B16","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1186\/s13256-023-03963-5","article-title":"Insulinoma with peripheral neuropathy: a case report","volume":"17","author":"Vinhosa Bastos","year":"2023","journal-title":"J Med Case Rep"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.39.5.465","article-title":"Muscle wasting after prolonged hypoglycaemic coma: case report with electrophysiological data","volume":"39","author":"Harrison","year":"1976","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B18","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1097\/00005792-198201000-00004","article-title":"Hypoglycemic peripheral neuropathy in association with insulinoma: implication of glucopenia rather than hyperinsulinism. Case report and literature review","volume":"61","author":"Jaspan","year":"1982","journal-title":"Med (Baltimore)"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.59.689.189","article-title":"A case of insulinoma with peripheral neuropathy","volume":"59","author":"Jayasinghe","year":"1983","journal-title":"Postgrad Med J"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-199111000-00001","article-title":"Spatial distribution of fiber degeneration in acute hypoglycemic neuropathy in rat","volume":"50","author":"Yasaki","year":"1991","journal-title":"J Neuropathol Exp Neurol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.2337\/diab.36.7.853","article-title":"Anterograde fast component of axonal transport during insulin-induced hypoglycemia in nondiabetic and diabetic rats","volume":"36","author":"Sidenius","year":"1987","journal-title":"Diabetes"},{"key":"B22","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1002\/dmrr.395","article-title":"Peripheral neuropathy and microangiopathy in rats with insulinoma: association with chronic hyperinsulinemia","volume":"19","author":"Sugimoto","year":"2003","journal-title":"Diabetes Metab Res Rev"},{"key":"B23","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1016\/j.ejphar.2018.06.034","article-title":"Molecular mechanism of diabetic neuropathy and its pharmacotherapeutic targets","volume":"833","author":"Dewanjee","year":"2018","journal-title":"Eur J Pharmacol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1007\/s10787-025-01729-7","article-title":"Flavonoids regulating NLRP3 inflammasome: a promising approach in alleviating diabetic peripheral neuropathy","volume":"33","author":"Khanna","year":"2025","journal-title":"Inflammopharmacology"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2026.1766149","article-title":"From glycemic instability to neuropathic risk: a propensity score-matched retrospective cohort study","volume":"17","author":"Yan","year":"2026","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2020.102668","article-title":"Treatment induced neuropathy of diabetes","volume":"226","author":"Gibbons","year":"2020","journal-title":"Auton Neurosci"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1924634\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:52:50Z","timestamp":1787921570000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1924634\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":26,"alternative-id":["10.3389\/fendo.2026.1924634"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1924634","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]},"article-number":"1924634"}}