Abstract
We report herein the cases of two women, aged 34 years and 39 years, respectively, found to have hyperin-sulinemic hypoglycemia after presenting with a history of episodes of temporary loss of consciousness, nausea, and fainting. Under the suspected diagnosis of insulinoma, localization procedures were carried out, but no tumor was found. In both patients, a definite gradient in insulin concentration was found in the pancreas by percutaneous transhepatic or intraoperative portal venous sampling, and a misdiagnosis of insulinoma of the pancreatic body was made. During exploratory laparotomy no tumor was palpable in the pancreas, and intraoperative ultrasonography showed no low echoic mass in the pancreas. A distal pancreatectomy was performed in both patients, and histopathological examination of the resected specimens revealed graded slight hyperplasia of the islet cells.
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References
Laidlaw GF (1938) Nesidioblastoma, the islet tumor of the pancreas. Am J Pathol 2:125–134
Harness JK, Geelhoed GW, Thompson NW, Nishiyama RH, Fajans SS, Kraft Ro, Howard DR, Clark KA (1981) Nesidioblastosis in adults. Arch Surg 116:575–580
Harrison TS, Fajans SS, Floyd JC, Thompson NW, Rasbach DA, Santen RJ, Cohen C (1984) Prevalence of diffuse pancreatic beta cell disease with hyperinsulinism: problems in recognition and management. World J Surg 8:583–589
Gould VE, Chejfec G, Shah K, Paloyan E, Lawrence AM (1984) Adult nesidioblastosis. Semin Diagn Pathol 1:43–53
Albers N, Lohr M, Bogner U, Loy V, Kloppel G (1989) Nesidioblastosis of the pancreas in an adult with persistent hyperinsulinemic hypoglycemia. Am J Clin Pathol 91:336–340
Fong TL, Warner NE, Kumar D (1989) Pancreatic nesidioblastosis in adults. Diabetes Care 12:108–114
McHenry C, Newell K, Chejfec G, Barbato A, Lawrence AM, Brooks M, Emanuele MA, Paloyan E (1989) Adult nesidioblastosis: an unusual case of fasting hypoglycemia. Am J Surg 55:366–369
Mozell EJ, Woltering EA, O’Dorisio TM, Phillioson BE, Flecher WS, Howe B, Hill D, Rhea D (1990) Adult onset nesidioblastosis: response of glucose, insulin, and secondary peptides to therapy with Sandostatin. Am J Gastroenterol 85:181–188
Martinez Valls JF, Ascaso JF, Ferrandez A, Hernandez A, Gonzalez Bayo E, Carmena R (1990) Hyperplasia of the pancreatic islets or nesidioblastosis in adult? Apropos 2 cases. Med Clin (Barc) 95:341–343
Andrews R, Balsitis M, Shurrock K, Jeffcoate WJ (1992) Nesidioblastosis in adults. Postgrad Med J 68:389–390
Farly DR, van Heerden JA, Myers JL (1994) Adult pancreatic nesidioblastosis. Arch Surg 129:329–332
Walmsley D, Matheson NA, Ewen S, Himsworth RL, Bevan JS (1995) Nesidioblastosis in an elderly patient. Diabetic Med 12:542–545
Galizia AC, Fava S, Foale R (1996) Nesidioblastosis-associated hypoglycemia presenting with prominent cardiac manifestations. Postgrad Med J 846:231–232
Kim HK, Shong YK, Han DJ, Cho Y, Lee IC, Kim GS (1996) Nesidioblastosis in an adult with hyperinsulinemic hypoglycemia. Endocr J 43:163–167
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Eriguchi, N., Aoyagi, S., Hara, M. et al. Nesidioblastosis with hyperinsulinemic hypoglycemia in adults: Report of two cases. Surg Today 29, 361–363 (1999). https://doi.org/10.1007/BF02483064
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DOI: https://doi.org/10.1007/BF02483064