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Case Report: A case of occult insulinoma localized by [18F] FB (ePEG12)12-exendin-4 positron emission tomography with negative findings of selective arterial calcium stimulation test.

Case ReportVery Low evidence

This record provides bibliographic details and links to the original research. An editorial study breakdown is not available.

What the researchers found

A GLP-1 receptor-targeted PET scan (18F-exendin-4) found an occult insulinoma that CT, MRI, endoscopic ultrasound, and calcium stimulation testing all missed, enabling curative surgery.

Why it matters

Insulinomas are hard to find with standard imaging. GLP-1 receptor PET offers a new non-invasive option that may locate tumors when everything else fails.

The numbers in context

1 patient; age 67 at onset, 73 at surgery; 6 years on diazoxide; negative on CT, MRI, EUS, and SACST; positive on 18F-exendin-4 PET/CT; complete remission post-surgery

How the study worked

Single case report describing diagnostic workup including CT, MRI, EUS, SACST, and 18F-exendin-4 PET/CT, followed by surgical resection and histopathology.

Who was studied

73-year-old woman with hyperinsulinemic hypoglycemia and occult insulinoma

What this study cannot tell us

Single case. Availability of 18F-exendin-4 PET/CT is very limited. Cost-effectiveness unknown. Cannot determine sensitivity/specificity from one case.

Read the original research

Case Report: A case of occult insulinoma localized by [18F] FB (ePEG12)12-exendin-4 positron emission tomography with negative findings of selective arterial calcium stimulation test.

Frontiers in endocrinology, 16, 1556813

Citation

Sakaki, Kentaro; Murakami, Takaaki; Fujimoto, Hiroyuki; Shimizu, Yoichi; Miyake, Kanae Kawai; Otani, Daisuke; Otsuki, Shinya; Shimizu, Hironori; Nagai, Kazuyuki; Nomura, Takumi; Yabe, Daisuke; Nakamoto, Yuji; Inagaki, Nobuya. (2025). Case Report: A case of occult insulinoma localized by [18F] FB (ePEG12)12-exendin-4 positron emission tomography with negative findings of selective arterial calcium stimulation test.. Frontiers in endocrinology, 16, 1556813. https://doi.org/10.3389/fendo.2025.1556813