title: A 14-year old girl with reversible hypoglycemic episodes: the role of ASVS.
abstract: We present the case of a 14-year-old female who experienced several episodes of reversible altered mental status triggered by hypoglycemia. Following endocrine investigation, she was diagnosed with insulinoma. Insulinoma, a rare, differentiated, and functioning neuroendocrine tumor of the pancreas overproduces insulin, thus leading to hypoglycemic episodes. Conventional imaging failed to detect the lesion; therefore, arterial calcium stimulation with venous sampling (ASVS) was used for preoperative localization. The patient recovered without complications after surgical enucleation of the tumor. The ASVS is a useful method for localizing insulinomas when conventional imaging techniques fail, and can help reduce morbidities associated with surgical excision.
authors.affiliation: 1 Department of Pathology and Laboratory, Cook Children's Medical Center, Fort Worth, Texas 76104, USA.
authors.forename: Alisha
authors.initials: A
authors.lastname: Smith
authors.forename: Paul S
authors.initials: PS
authors.lastname: Thornton
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Galliani
authors.forename: James P
authors.initials: JP
authors.lastname: Miller
authors.forename: Jennifer
authors.initials: J
authors.lastname: Dykes
authors.forename: Van
authors.initials: V
authors.lastname: Leung-Pineda
mesh_terms: D000293:Adolescent; D001158:Arteries / Q000378:metabolism*; D001786:Blood Glucose / Q000032:analysis; D002118:Calcium / Q000097:blood* / Q000378:metabolism*; D049109:Cell Proliferation; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism* / Q000628:therapy; D007340:Insulinoma / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D018358:Neuroendocrine Tumors / Q000175:diagnosis; D014680:Veins / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D002118:Calcium
keywords: altered mental status; calcium stimulation; insulinoma; pediatric hypoglycemia