Development of multifocal nodular lesions of a liver mimicking hepatic metastasis, following resection of an insulinoma in a child.
- Author:
Sook Young JUNG
1
;
Ben KANG
;
Yoon Mee CHOI
;
Jun Mee KIM
;
Soon Ki KIM
;
Young Se KWON
;
Ji Eun LEE
Author Information
- Publication Type:Case Report
- Keywords: Insulinoma; Focal nodular hyperplasia; Neoplasm metastasis; Pediatrics
- MeSH: Biopsy; Child*; Female; Focal Nodular Hyperplasia; Humans; Hyperinsulinism; Hypoglycemia; Insulin-Secreting Cells; Insulinoma*; Liver*; Magnetic Resonance Imaging; Necrosis; Neoplasm Metastasis*; Pancreatectomy; Pediatrics; Seizures; Ultrasonography
- From:Korean Journal of Pediatrics 2015;58(2):69-72
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
