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KMID : 1130320150580020069
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Korean Journal of Pediatrics
2015 Volume.58 No. 2 p.69 ~ p.72
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Development of multifocal nodular lesions of a liver mimicking hepatic metastasis, following resection of an insulinoma in a child
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Jung Sook-Young
Kang Ben
Choi Yoon-Mee
Kim Jun-Mee
Kim Soon-Ki
Kwon Young-Se
Lee Ji-Eun
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Abstract
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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-yearold 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.
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KEYWORD
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Insulinoma, Focal nodular hyperplasia, Neoplasm metastasis, Pediatrics
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