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[Insulinoma in childhood--report of a case]
1Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C.
Insights
Recurrent hypoglycemia in a 14-year-old boy was caused by an insulinoma. Surgical removal of the pancreatic tumor resolved the condition, highlighting the importance of insulin level testing in pediatric hypoglycemia.
Area of Science:
- Pediatric Endocrinology
- Surgical Oncology
Background:
- Recurrent hypoglycemia presents a diagnostic challenge in pediatric patients.
- Identifying the underlying cause is crucial for effective treatment and management.
Observation:
- A 14-year-old male experienced recurrent hypoglycemia over six months.
- Episodes were associated with inappropriately high serum insulin levels.
- Symptoms improved with intravenous glucose administration.
Findings:
- Abdominal CT revealed a 1 cm pancreatic tail mass.
- Tumor enucleation confirmed insulinoma.
- Postoperative recovery was uneventful with no further hypoglycemic episodes.
Implications:
- Early diagnosis and surgical intervention are key for treating pediatric insulinoma.
- Measuring plasma insulin levels during hypoglycemic attacks is essential for diagnosis in children.
- This case underscores the successful management of pediatric insulinoma through prompt diagnosis and surgical treatment.
Abstract:
A 14-year-old boy was having recurrent hypoglycemia over the past 6 months, so he was brought to our hospital for further evaluation. During the episodes of hypoglycemia, his serum insulin level was inappropriately high and the symptoms of hypoglycemia were dramatically ameliorated by intravenously administering glucose bolus. Computed tomography of the abdomen revealed a 1 x 1 cm mass located at the tail of the pancreas. Under the impression of an insulinoma, enucleation of the tumor was performed smoothly, and the pathological finding confirmed the diagnosis. The postoperative course was smooth and no episodes of hypoglycemia were noted after treatment. In children with hypoglycemic attacks, adequate blood sampling before correction to determine plasma insulin levels is essential.