Imaging led to a definitive diagnosis for a 71-year-old female who presented to the endocrine clinic for evaluation of hypoglycemia. The patient was noted to have frequent episodes of symptomatic hypoglycemia for 2 years prior to presentation. Symptoms included weakness, diaphoresis, and perioral numbness. The symptoms would resolve after treatment with carbohydrate-rich foods or drinking juice. During this time, she had an unintentional weight gain of 40, as well as several experiences of severe hypoglycemia, which required emergency services assistance.