de Vogelaere Kristel, De Schepper Jean, Vanhoeij Marjan, De Mey Johan, Goossens Anita, Vanbesien Jesse, De Backer Antoine, Delvaux Georges
Department of Surgery, Vrije Universiteit Brussel, Brussels, Belgium.
J Laparoendosc Adv Surg Tech A. 2006 Jun;16(3):335-8. doi: 10.1089/lap.2006.16.335.
The diagnosis and surgical management of insulinomas associated with multiple endocrine neoplasia type 1 (MEN1) pose additional problems in children because of the long-term risk of recurrence of other pancreatic and non-pancreatic tumors. We report a diagnostic confirmation by laparoscopic ultrasound of an insulinoma and its successful removal by laparoscopic enucleation in an 8- year-old boy who was admitted to our hospital with a history of recurrent episodes of absences, headache, and visual and auditive disturbances diagnosed as hyperinsulinism-related hypoglycemia. Magnetic resonance imaging of the pancreas showed a small contrast-enhancing lesion in the body of the pancreas, suspected for insulinoma. MEN1 was genetically proven by direct DNA testing. A pancreatic tumor can arise before the age of 10 in patients with MEN1 and can be surgically treated by a laparoscopical approach.
由于存在其他胰腺和非胰腺肿瘤复发的长期风险，与1型多发性内分泌腺瘤病（MEN1）相关的胰岛素瘤的诊断和外科治疗在儿童中带来了额外的问题。我们报告了1例8岁男孩，因反复出现失神发作、头痛以及视觉和听觉障碍，被诊断为与高胰岛素血症相关的低血糖症而入院。经腹腔镜超声诊断确诊为胰岛素瘤，并通过腹腔镜摘除成功切除。胰腺磁共振成像显示胰腺体部有一个小的强化病变，怀疑为胰岛素瘤。通过直接DNA检测在基因上证实了MEN1。MEN1患者的胰腺肿瘤可在10岁之前出现，可通过腹腔镜手术治疗。
