Adult Nesidioblastosis With Hypoglycemia Mimicking an Insulinoma: A Challenging Case

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dc.contributor.authorYurekli, Banu Sarer
dc.contributor.authorKutbay, Nilufer Ozdemir
dc.contributor.authorAltun, Ilker
dc.contributor.authorCetinkalp, Sevki
dc.contributor.authorNart, Deniz
dc.contributor.authorCoker, Ahmet
dc.contributor.authorOzgen, Gokhan
dc.date.accessioned2019-10-27T11:07:15Z
dc.date.available2019-10-27T11:07:15Z
dc.date.issued2017
dc.departmentEge Üniversitesien_US
dc.description.abstractIntroduction: Nesidioblastosis is the primary cause of persistent hyperinsulinemic hypoglycemia in infants but it is a rare entity for the adults. Nesidioblastosis is defined as an increase of pancreatic beta cells in number and in size. Case Presentation: We describe a rare case of nesidioblastosis with positive endoscopic ultrasonography result mimicking an insulinoma. A 35-year-old female patient had hypoglycemic episodes with high insulin level. Her investigation revealed low venous plasma glucose, high insulin and C-peptide level with positive 72-hour fasting test suggestive of hyperinsulinemic hypoglycemia. Abdominal computed tomography did not show any mass lesion. Endoscopic ultrasonography revealed a mass lesion sized as 1 cm in diameter in the pancreas. But, insulinoma like lesion couldn't be found intra-operatively. It was decided to perform distal pancreatectomy. After distal pancreatectomy, nesidioblastosis was diagnosed histopathologically. The patient was free from her symptoms after surgery. Conclusion: This case illustrates difficulties and limitations of imaging modalities and false positive result of EUS in a case of nesidioblastosis. When there is no insulinoma like lesion during operation, operation should be performed as gradient guided pancreatectomy by the way of selective arterial calcium injection test.en_US
dc.identifier.doi10.9738/INTSURG-D-17-00020.1
dc.identifier.endpage327en_US
dc.identifier.issn0020-8868
dc.identifier.issn0020-8868en_US
dc.identifier.issue07.Augen_US
dc.identifier.startpage324en_US
dc.identifier.urihttps://doi.org/10.9738/INTSURG-D-17-00020.1
dc.identifier.urihttps://hdl.handle.net/11454/31999
dc.identifier.volume102en_US
dc.identifier.wosWOS:000443007400007en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.language.isoenen_US
dc.publisherInt College Of Surgeonsen_US
dc.relation.ispartofInternational Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectnesidioblastosisen_US
dc.subjectendoscopic ultrasonographyen_US
dc.subjectinsulinomaen_US
dc.titleAdult Nesidioblastosis With Hypoglycemia Mimicking an Insulinoma: A Challenging Caseen_US
dc.typeArticleen_US

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