A 43-year-old woman comes to the office due to episodic confusion, blurred vision, tremors, and sweating. The episodes have increased in intensity over the past few months and can occur any time of day. Symptoms are relieved by drinking orange juice. During a recent episode, her blood glucose was 32 mg/dL on a home glucose meter. Laboratory studies performed during a symptomatic episode are obtained. Which of the following is the most likely cause of this patient's symptoms?
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