ESPE Abstracts

Aims: To report case presenting with pediatric insulinoma.

Methods: A case with pediatric insulinoma was reviewed including demographic and clinical data.

Results: A 11-year-old boy was referred from private hospital due to hypoglycemia. He has a 1-month history of increased hunger, increased 10 kg of weight, confusion and fainting after fasting 10 h. On examination, height was 50th centile, weight was 90th centile, there were no cushingoid appearance, no hirsutism, normotension, systematic examinations were normal. Initial investigation from private hospital showed low blood glucose (BS 10 mg/dl) and return to normal after giving intravenous glucose bolus. We performed fasting study and found hypoglycemia 6 h after fasting. Blood was drawn and found low glucose with high insulin (10 μU/ml) levels but normal cortisol level. An abdominal contrast-enhanced computed tomography scan show 2 small well-demarcated heterogeneously enhancing lesion within the body and tail of pancreas without dilatation of pancreatic duct. The patient was diagnosis as having insulinoma. Minimally invasive surgery endoscopic laparotomy was operated to remove pancreatic mass and found 3 mass at pancreas (the last one is in the pole of pancreas). Histopathology confirmed insulinoma. Blood glucose and insulin are in normal level within a month after surgery. Three years times follow up has complete recovery and no evidence of tumor recurrence.

Conclusions: Pediatric insulinoma should be considered in any young child presenting with hypoglycemia symptoms. It is managed effectively with tumor removal using minimally invasive procedures.