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Insulinoma in childhood
O Panamonta1, S Areemit, J Srinakarin
1Department of Pediatrics, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Thailand.
Summary
A boy with intractable convulsions was diagnosed with hyperinsulinism caused by a pancreatic tumor. Surgical removal of the tumor led to successful treatment, highlighting the importance of pancreatic tumor diagnosis in pediatric epilepsy.
Area of Science:
- Pediatric Endocrinology
- Surgical Oncology
- Neuroscience
Background:
- Epilepsy and adrenal insufficiency are challenging pediatric conditions.
- Persistent symptoms despite standard treatment warrant further investigation.
Observation:
- A 9-year-old boy presented with convulsions unresponsive to epilepsy and adrenal insufficiency treatments.
- Imaging studies identified a pancreatic tail tumor as the source of hyperinsulinism and hypoglycemia.
Findings:
- Surgical resection (distal pancreatectomy) of the islet cell tumor resolved the patient's hyperinsulinism and hypoglycemia.
- Histological examination revealed islet cell tumors with capsular invasion.
Implications:
- This case underscores the significance of considering pancreatic tumors in pediatric epilepsy with unexplained hypoglycemia.
- Long-term surveillance for metastasis, recurrence, and Multiple Endocrine Neoplasia type 1 is crucial for affected patients.