title: Nesidioblastosis as a cause of focal pancreatic 111In-pentetreotide uptake in a patient with putative VIPoma: another differential diagnosis.
abstract: In adults, nesidioblastosis is a very infrequent condition and a rare cause of symptomatic presentations. The diagnosis of nesidioblastosis may be difficult with functional and anatomical imaging modalities. "Slight focal" pancreatic abnormalities using (111)In-pentetreotide imaging has been reported in patients with hyperinsulinaemic hypoglycaemia, confirmed histologically as nesidioblastosis. We describe a 60-year-old man who presented with a 1-year history of intermittent faecal urgency and refractory diarrhoea, non-specific laboratory results, negative imaging results (CT, MRI and EUS), a FNA biopsy that was inconclusive, but suggested an endocrine cell neoplasm, and a (111)In-pentetreotide scan that showed a moderately intense focal uptake clearly localised to the pancreatic head on a low-dose fusion CT. The histopathology of the specimen confirmed the diagnosis of nesidioblastosis.
authors.affiliation: Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Brisbane, QLD 4029, Australia. alessandra_francesconi@health.qld.gov.au
authors.forename: Alessandra Bastian
authors.initials: AB
authors.lastname: Francesconi
authors.forename: Marco
authors.initials: M
authors.lastname: Matos
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Lee
authors.forename: David K
authors.initials: DK
authors.lastname: Wyld
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Clouston
authors.forename: David
authors.initials: D
authors.lastname: Macfarlane
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D046768:Nesidioblastosis / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D010179:Pancreas / Q000000981:diagnostic imaging / Q000378:metabolism*; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000378:metabolism; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D003969:Vipoma / Q000175:diagnosis*
chemical_list: D013004:Somatostatin; C081788:pentetreotide