Abstract
Insulinomas are the most prevalent hormone-producing pancreatic neuroendocrine neoplasms (panNEN). Surgical resection of these tumors is frequently curative and is currently the mainstay treatment for preventing long-term brain damage caused by hypoglycemia. Stereotactic body radiation therapy (SBRT) is an external radiation therapy utilizing specific equipment for positioning patients and delivering a focused radiation dose to tumors in the body over a series of sessions while fostering minimal radiation exposure to surrounding healthy tissue. This report presents a six-year follow-up and comprehensive update of a previously published case of insulinoma treated with SBRT, including new imaging, biochemical outcomes, detailed SBRT planning methodology, and an updated literature review. These additions provide long-term insight into SBRT as a high-precision alternative for patients who decline or are unfit for surgery.