Insulinoma is the most common pancreatic neuroendocrine tumor. The clinical manifestation is diverse, some of which may cause irreversible neurological deficits due to persistent hypoglycemia. This article reports a case of a 17-year-old patient who presented with visual scotoma, somnolence and loss of consciousness with blood glucose documentation of 15 mg / dL. He was admitted and underwent imaging tests. Tomography and Magnetic Resonance imaging did not clearly identify the pancreatic lesion, but tumor lesions were identified after arterial stimulation with calcium. Patient was submitted to surgical enucleation by laparotomy. In this context, there is still much discussion about the optimal sequence of exams for the exact tumor location. However, the use of less invasive exams such as arterial calcium stimulation is essential for adequate surgical resection.

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