Insulinoma in childhood.

Mann, J R; Rayner, P H; Gourevitch, A.

doi:10.1136/adc.44.236.435

Cited by 34 publications

(7 citation statements)

References 29 publications

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“…Most of the episodes occurred during the morning hours, after exercise or fasting, and resolved after food or juice intake [ 9 , 10 , 14 , 15 , 17 – 19 , 27 ]. Eighteen children experienced seizure activity [ 13 , 14 , 16 , 18 – 21 , 23 – 25 , 27 , 29 , 30 ], four children were found in a comatose state [ 29 , 30 ], three children had mental retardation as sequelae after surgery [ 11 , 27 , 30 ] and two children died [ 22 , 30 ]. Duration of hypoglycemia symptoms before the diagnosis of insulinoma in children ranged from 1 month to 7 years, and averaged 10–13.4 months [ 14 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Insulinoma masquerading as a loss of consciousness in a teenage girl: case report and literature review

Gudala

Ahmed

Conroy

et al. 2017

Int J Pediatr Endocrinol

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BackgroundHypoglycemia due to a pancreatic beta cell neoplasm - insulinoma, is uncommon with only a few cases described. We report on a previously healthy 15-year-old Hispanic female with insulinoma who presented with a loss of consciousness due to hypoglycemia unawareness.Case presentationEM was first brought to the emergency department (ED) after she was found unresponsive at home with point of care (POC) glucose of 29 mg/dL(1.6 mmol/L) documented by emergency medical services (EMS) upon arrival. After treatment with dextrose and normal laboratory evaluation, including complete blood count, basal metabolic profile and urine drug screen, she was sent home with recommendations to follow-up the next day with an endocrinologist. Due to insurance issues, the family did not keep the appointment. Two days later, she returned to the ED with POC of 19 mg/dL (1.05 mmol/L). Detailed history review identified vague fatigue, excessive sleepiness, poor oral intake and weight gain for a 2–3 month period and no suspicion for drug, alcohol or prescription medication abuse. Family history of multiple endocrine neoplasia was negative. Physical examination revealed mild acanthosis nigricans and a body mass index of 32.8 kg/m2 (98th percentile). Laboratory evaluation showed elevated insulin with low cortisol and growth hormone levels at the time of hypoglycemia. Abdominal magnetic resonance imaging revealed a pancreatic mass, also supported by ultrasound, computed tomography and positron emission tomography scans. The patient underwent a partial pancreatectomy with removal of a well-circumscribed insulinoma from the anterior-superior aspect of the pancreatic neck confirmed by histology. Hypoglycemia resolved post-operatively and she remained euglycemic during a 48-h cure fast. At her 3-month follow-up visit, she had no symptoms of hypoglycemia.ConclusionDocumented hypoglycemia in an otherwise healthy adolescent should be fully investigated before discharging a patient. Even a short duration of symptoms should prompt, in-depth diagnostic evaluations to rule out a potentially life threatening diagnosis of insulinoma.

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Section: Discussionmentioning

confidence: 99%

Insulinoma masquerading as a loss of consciousness in a teenage girl: case report and literature review

Gudala

Ahmed

Conroy

et al. 2017

Int J Pediatr Endocrinol

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“…Mann et al carried out an extensive review of the literature in 1969 and found only 41 cases 5 , of which only two were malignant. Mann et al carried out an extensive review of the literature in 1969 and found only 41 cases 5 , of which only two were malignant.…”

Section: Discussionmentioning

confidence: 99%

Malignant Insulinoma in Childhood

Karachaliou

Vlachopapadopoulou²,

Kaldrymidis³

et al. 2006

Journal of Pediatric Endocrinology and Metabolism

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Pancreatic tumors constitute a rare surgical problem in infancy and childhood. Insulinomas are rare in all age groups with an estimated incidence of one per 250,000 person-years and even rarer in childhood. We report a 10 year-old girl with malignant insulinoma. The presenting symptom was hypoglycemic attacks. Laboratory investigation demonstrated that the hypoglycemia was due to hyperinsulinism. MRI of the abdomen revealed a mass at the tail of the pancreas. Distal pancreatectomy with splenectomy was performed. Histological examination showed malignant insulinoma with peripancreatic lymph node metastases. One month later abdominal MRI revealed the existence of multiple small metastatic foci in the liver, which were confirmed by In111 octreoscan. Treatment with octreotide was started and the disease is stable after 12 months of therapy.

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“…Na presente série, a incidência foi de 58,3% para o sexo feminino e 41,7% para o masculino. A idade dos pacientes incidiu com maior freqüência entre a 3 a e a 7 a décadas, dados compatíveis com os da literatura, embora existam relatos da doença nos extremos da vida (16,27) .…”

Section: Discussionunclassified