Secondary adrenal insufficiency during hypoglycemia caused by insulinoma: a case report and literature review

Abstract Background Insulinoma is a rare neuroendocrine tumor that is usually benign, but it can be life-threatening due to the hypoglycemic events it causes. Adrenal insufficiency can also be a cause of hypoglycemia. In a normal physiological response, the occurrence of hypoglycemia can stimulate cortisol secretion. Case presentation We report a case of a young female patient with hypoglycemia who was diagnosed with insulinoma and adrenal insufficiency based on symptoms and laboratory tests，and was then given her hydrocortisone therapy. Hormone replacement therapy was discontinued after surgical removal of the insulinoma. Three months postoperatively, the patient did not develop hypoglycemia. In addition, levels of adrenocorticotropic hormone and cortisol are also shown to be normal. Discussion and Conclusions This article discusses the role of insulinoma in causing adrenal insufficiency, shows that screening for adrenal cortex function in insulinoma patients can help control hypoglycemia and safely perform surgery, preventing the occurrence of more serious complications. This study also shows that postoperative follow-up to assess adrenal cortex function and timely adjustment of glucocorticoid dosage are proven to be necessary.