Laparoscopic management of insulinoma in a child with multiple endocrine neoplasia type 1.
The diagnosis and surgical management of insulinomas associated with multiple endocrine neoplasia type 1 (MEN1) pose additional problems in children because of the long-term risk of recurrence of other pancreatic and non-pancreatic tumors. We report a diagnostic confirmation by laparoscopic ultrasound of an insulinoma and its successful removal by laparoscopic enucleation in an 8- year-old boy who was admitted to our hospital with a history of recurrent episodes of absences, headache, and visual and auditive disturbances diagnosed as hyperinsulinism-related hypoglycemia. Magnetic resonance imaging of the pancreas showed a small contrast-enhancing lesion in the body of the pancreas, suspected for insulinoma. MEN1 was genetically proven by direct DNA testing. A pancreatic tumor can arise before the age of 10 in patients with MEN1 and can be surgically treated by a laparoscopical approach.
de Vogelaere
Kristel
K
Department of Surgery, Vrije Universiteit Brussel, Brussels, Belgium. hlkdvek@az.vub.ac.be
De Schepper
Jean
J
Vanhoeij
Marjan
M
De Mey
Johan
J
Goossens
Anita
A
Vanbesien
Jesse
J
De Backer
Antoine
A
Delvaux
Georges
G
D002648:Child; D003952:Diagnostic Imaging; D006801:Humans; D007340:Insulinoma / Q000473:pathology* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D018761:Multiple Endocrine Neoplasia Type 1 / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*