MEN1 and pancreatic insulinoma: These lesions are very rare, with around 1 to 4 new cases occurring per million persons per year, and particularly uncommon in children—the mid-20th century medical literature only gathering dozens of isolated or small series of cases.7–11 Although most insulinomas are solitary and sporadic—such as in our case —10% of them occur in connection with MEN1.12–14 Most insulinomas are benign, but up to 10% can be malignant.14,15 The clinical presentation of patients includes neuroglycopenic symptoms such as loss of consciousness, lethargy, confusion, dizziness, recurrent seizures, and coma.