Clinical Presentation and Outcomes of Insulinomas in Pediatric Patients
Authors' conclusion
In this series, successful treatment of insulinomas took, on average, 9 weeks from diagnosis. Multiple imaging modalities were employed for preoperative lesion localization, with 18F-DOPA PET/CT and magnetic resonance imaging being the most successful. Improved imaging modalities are needed to localize insulinomas in pediatric patients and reduce the time between diagnosis and resection. We propose an algorithm to differentiate between pediatric insulinomas and congenital hyperinsulinism using laboratory data to quicken diagnosis and lessen time to treatment.
Study context
- Population
- Pediatric patients with confirmed insulinoma treated at a single academic pediatric hospital, 2006–2024; median age at presentation 13 years
- Participants
- 23 patients
- Outcome
- Clinical presentation, localization, treatment and outcomes
Methodological detailssingle-centre, academic pediatric hospital
- Single-centre
- Academic pediatric hospital
Main finding
As reported in the abstract
- Positive family history of MEN1
- 22%
- Most common presenting symptom
- altered mental status
- Median plasma insulin during hypoglycemia
- 8.8 uIU/mL (61.1 pmol/L)
- Median BOHB during hypoglycemia
- 0.3 mmol/L
- Single lesion successfully resected and cured
- 20 of 23
- 18F-DOPA PET/CT positive, among 12 of the 20 cured with the scan
- nine (75%)
- Lesions resected but continued hypoglycemia requiring medical management
- 3
- Median duration from presentation to surgery
- 9 weeks
Observational data: associations, not effects.
Further findings
Discrimination of insulinoma vs hyperinsulinism (HI): BOHB plus IGF binding protein 1 at hypoglycemia (multivariate function)
- Sensitivity
- 0.89
- Specificity
- 0.84
- Optimal operating point
Original publication
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