title: Malignant insulinoma in childhood.
abstract: 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.
authors.affiliation: Department of Growth and Development, P & A Kyriakou Children's Hospital, Pireaus, Greece.
authors.forename: Feneli
authors.initials: F
authors.lastname: Karachaliou
authors.forename: Elpis
authors.initials: E
authors.lastname: Vlachopapadopoulou
authors.forename: Philipos
authors.initials: P
authors.lastname: Kaldrymidis
authors.forename: George
authors.initials: G
authors.lastname: Simatos
authors.forename: Maria
authors.initials: M
authors.lastname: Zacharea
authors.forename: Erini
authors.initials: E
authors.lastname: Spanidou-Karvouni
authors.forename: Stefanos
authors.initials: S
authors.lastname: Michalacos
authors.forename: Dionyssios
authors.initials: D
authors.lastname: Voros
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology; D007340:Insulinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D008113:Liver Neoplasms / Q000556:secondary; D008279:Magnetic Resonance Imaging; D015282:Octreotide / Q000627:therapeutic use; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011877:Radionuclide Imaging; D013156:Splenectomy
chemical_list: D018931:Antineoplastic Agents, Hormonal; D015282:Octreotide