Case report: focal nesidioblastosis (“nesidioblastoma”) in an adult

• Published in: Human pathology Vol. 41; no. 3; pp. 447 - 451
• Main Authors: McElroy, Michele K., MD, Lowy, Andrew M., MD, Weidner, Noel, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2010; Elsevier; Elsevier Limited
• Subjects: Adult; Adult nesidioblastosis; Biological and medical sciences; Blood Glucose - analysis; Diabetes; Glucose; Humans; Hypoglycemia - etiology; Hypoglycemia - surgery; Insulin; Insulin-Secreting Cells - pathology; Investigative techniques, diagnostic techniques (general aspects); Male; Medical imaging; Medical sciences; Nesidioblastosis - complications; Nesidioblastosis - pathology; Nesidioblastosis - surgery; Pancreas; Pancreas - pathology; Pancreas - surgery; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Persistent hyperinsulinemic hypoglycemia; Polypeptides; Treatment Outcome; Persistent hyperinsulinemic hypoglycemia; Adult nesidioblastosis; Endocrinopathy; Human; Case study; Hyperinsulinemia; Anatomic pathology; Metabolic diseases; Adult; Tumor; Hypoglycemia; Endocrine pancreas
• ISSN: 0046-8177; 1532-8392
• DOI: 10.1016/j.humpath.2009.09.002

Summary Adult nesidioblastosis is an uncommon cause of hyperinsulinemic hypoglycemia characterized by diffuse islet hyperplasia with β -cell hypertrophy and atypia. The cause of nesidioblastosis in adults is unclear but may be different from nesidioblastosis in infants. In contrast to infants, a focal form of adult nesidioblastosis (ie, “nesidioblastoma”) has not been documented, although proposed. We report a 44-year-old man with symptomatic hypoglycemia and localized nesidioblastosis treated with surgical enucleation resulting in normalization of blood glucose. Postoperative euglycemia has persisted in this patient to date (4 months at the time of manuscript submission).