Recurrent Syncope, Behavioral Changes and Weight Gain in an Elderly Filipino Woman: Successful Diagnosis and Management of Insulinoma With 13-Year Disease-Free Follow-up.
Recurrent syncope and behavioral changes in the older population may suggest several disease entities associated with aging. Hypoglycemia is an often-missed potentially correctable underlying cause that should also be considered in the differential diagnosis. We present a case of a 62-year-old Filipino female who presented with recurrent syncopal attacks, behavioral changes and unintentional weight gain, associated with endogenous hyperinsulinemic hypoglycemia with no pancreatic mass seen on abdominal CT scan. A pancreatic head tumor was visualized through endoscopic ultrasound. Surgical removal of the mass resulted in resolution of her symptoms and restoration of her physical and functional wellbeing. This case is being reported to highlight that surgery cured her of the disease and she remains asymptomatic and well 13 years after her surgery.