Development of multifocal nodular lesions of a liver mimicking hepatic metastasis, following resection of an insulinoma in a child
Insulinoma, which arises from insulin-producing pancreatic beta cells, is a rare tumor in children. Only 5%-10% of insulinomas are malignant and undergo metastasis. We report a case of an 11-year-old girl who experienced hypoglycemia-related seizures induced by an insulinoma; after resection of the...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Pediatric Society
2015-02-01
|
| Series: | Korean Journal of Pediatrics |
| Subjects: | |
| Online Access: | http://kjp.or.kr/upload/pdf/kjped-58-69.pdf |
| _version_ | 1818766483197526016 |
|---|---|
| author | Sook Young Jung Ben Kang Yoon Mee Choi Jun Mee Kim Soon Ki Kim Young Se Kwon Ji Eun Lee |
| author_facet | Sook Young Jung Ben Kang Yoon Mee Choi Jun Mee Kim Soon Ki Kim Young Se Kwon Ji Eun Lee |
| author_sort | Sook Young Jung |
| collection | DOAJ |
| description | Insulinoma, which arises from insulin-producing pancreatic beta cells, is a rare tumor in children. Only 5%-10% of insulinomas are malignant and undergo metastasis. We report a case of an 11-year-old girl who experienced hypoglycemia-related seizures induced by an insulinoma; after resection of the primary tumor, she developed hepatic focal nodular hyperplasia (FNH). Laboratory test results indicated marked hypoglycemia with hyperinsulinemia. Abdominal ultrasonography (US) and computed tomography results were normal; however, magnetic resonance imaging (MRI) showed a solid mass in the pancreatic tail. Therefore, laparoscopic distal pancreatectomy was performed. Two months after the surgery, an abdominal MRI revealed multiple nodular lesions in the liver. An US-guided liver biopsy was then performed, and histological examination revealed FNH without necrosis or mitotic activity. The patient has been free of hypoglycemia for 2 years, and recent MRI studies showed a decrease in the size of FNH lesions, without any evidence of metastasis. Even though no metastatic lesions are noted on imaging, close observation and follow-up imaging studies are required in a child with insulinoma that has malignant potential on histopathologic findings. |
| first_indexed | 2024-12-18T08:34:42Z |
| format | Article |
| id | doaj.art-625ec9ace6f44fa09524d4aa331398c8 |
| institution | Directory Open Access Journal |
| issn | 1738-1061 2092-7258 |
| language | English |
| last_indexed | 2024-12-18T08:34:42Z |
| publishDate | 2015-02-01 |
| publisher | Korean Pediatric Society |
| record_format | Article |
| series | Korean Journal of Pediatrics |
| spelling | doaj.art-625ec9ace6f44fa09524d4aa331398c82022-12-21T21:14:21ZengKorean Pediatric SocietyKorean Journal of Pediatrics1738-10612092-72582015-02-01582697210.3345/kjp.2015.58.2.692013600063Development of multifocal nodular lesions of a liver mimicking hepatic metastasis, following resection of an insulinoma in a childSook Young Jung0Ben Kang1Yoon Mee Choi2Jun Mee Kim3Soon Ki Kim4Young Se Kwon5Ji Eun Lee6Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.Department of Pathology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.Insulinoma, which arises from insulin-producing pancreatic beta cells, is a rare tumor in children. Only 5%-10% of insulinomas are malignant and undergo metastasis. We report a case of an 11-year-old girl who experienced hypoglycemia-related seizures induced by an insulinoma; after resection of the primary tumor, she developed hepatic focal nodular hyperplasia (FNH). Laboratory test results indicated marked hypoglycemia with hyperinsulinemia. Abdominal ultrasonography (US) and computed tomography results were normal; however, magnetic resonance imaging (MRI) showed a solid mass in the pancreatic tail. Therefore, laparoscopic distal pancreatectomy was performed. Two months after the surgery, an abdominal MRI revealed multiple nodular lesions in the liver. An US-guided liver biopsy was then performed, and histological examination revealed FNH without necrosis or mitotic activity. The patient has been free of hypoglycemia for 2 years, and recent MRI studies showed a decrease in the size of FNH lesions, without any evidence of metastasis. Even though no metastatic lesions are noted on imaging, close observation and follow-up imaging studies are required in a child with insulinoma that has malignant potential on histopathologic findings.http://kjp.or.kr/upload/pdf/kjped-58-69.pdfInsulinomaFocal nodular hyperplasiaNeoplasm metastasisPediatrics |
| spellingShingle | Sook Young Jung Ben Kang Yoon Mee Choi Jun Mee Kim Soon Ki Kim Young Se Kwon Ji Eun Lee Development of multifocal nodular lesions of a liver mimicking hepatic metastasis, following resection of an insulinoma in a child Korean Journal of Pediatrics Insulinoma Focal nodular hyperplasia Neoplasm metastasis Pediatrics |
| title | Development of multifocal nodular lesions of a liver mimicking hepatic metastasis, following resection of an insulinoma in a child |
| title_full | Development of multifocal nodular lesions of a liver mimicking hepatic metastasis, following resection of an insulinoma in a child |
| title_fullStr | Development of multifocal nodular lesions of a liver mimicking hepatic metastasis, following resection of an insulinoma in a child |
| title_full_unstemmed | Development of multifocal nodular lesions of a liver mimicking hepatic metastasis, following resection of an insulinoma in a child |
| title_short | Development of multifocal nodular lesions of a liver mimicking hepatic metastasis, following resection of an insulinoma in a child |
| title_sort | development of multifocal nodular lesions of a liver mimicking hepatic metastasis following resection of an insulinoma in a child |
| topic | Insulinoma Focal nodular hyperplasia Neoplasm metastasis Pediatrics |
| url | http://kjp.or.kr/upload/pdf/kjped-58-69.pdf |
| work_keys_str_mv | AT sookyoungjung developmentofmultifocalnodularlesionsofalivermimickinghepaticmetastasisfollowingresectionofaninsulinomainachild AT benkang developmentofmultifocalnodularlesionsofalivermimickinghepaticmetastasisfollowingresectionofaninsulinomainachild AT yoonmeechoi developmentofmultifocalnodularlesionsofalivermimickinghepaticmetastasisfollowingresectionofaninsulinomainachild AT junmeekim developmentofmultifocalnodularlesionsofalivermimickinghepaticmetastasisfollowingresectionofaninsulinomainachild AT soonkikim developmentofmultifocalnodularlesionsofalivermimickinghepaticmetastasisfollowingresectionofaninsulinomainachild AT youngsekwon developmentofmultifocalnodularlesionsofalivermimickinghepaticmetastasisfollowingresectionofaninsulinomainachild AT jieunlee developmentofmultifocalnodularlesionsofalivermimickinghepaticmetastasisfollowingresectionofaninsulinomainachild |