Management challenges in a child with hyperinsulinemic hypoglycemia.
Malignant insulinoma is very rare in children. Herein, we present a case of a child with malignant insulinoma along with islet cell hyperplasia. She initially presented with features of hyperinsulinemic hypoglycemia at 18 mo of age. Magnetic resonance imaging (MRI) of the abdomen showed a mass at the junction of the head and body of the pancreas. The tumor was enucleated. Five months later symptoms of hypoglycemia recurred. A subtotal pancreatectomy was performed. She continued to have hypoglycemia, although less frequently. She was put on increasing doses of diazoxide. Seven months later, MRI of the abdomen and a PET scan revealed metastatic deposits in the liver, which were confirmed by histopathology and immunostaining. To the best of our knowledge, this is the youngest child with metastatic insulinoma reported so far.
Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
Deepti
D
Chaturvedi
Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
Rajesh
R
Khadgawat
Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
Jeyaraman
J
Kanakamani
Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
Bindu
B
Kulshreshtha
Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
Devender K
DK
Gupta
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Asis Kumar
AK
Karak
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Sandeep R
SR
Mathur
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Kalyani K
KK
Kulkarni
Department of Radiology, All India Institute of Medical Sciences, New Delhi, India.
Ashu
A
Seith
Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
Ariachery C
AC
Ammini
childhood; liver metastasis; malignant insulinoma