Korean Diabetes J.  2009 Jun;33(3):251-256. 10.4093/kdj.2009.33.3.251.

Hypoglycemia due to Focal Nesidioblastosis in a Patient with Type 2 Diabetes Mellitus

• Lee EJ
• Song KH
• Kim SK
• Chang SH
• Kim DL

• KMID: 2222425
• DOI: http://doi.org/10.4093/kdj.2009.33.3.251

Abstract

We report a 45-year-old man with type 2 diabetes who presented with recurrent hypoglycemia. Biochemical and imagingstudies did not show any mass-like lesion in the pancreas, so prednisolone and diazoxide were administered for the treatment of hypoglycemia. However, the hypoglycemia persisted during and after the medical treatment. A selective arterial calcium stimulation test was performed and revealed a suspicious lesion at the head of the pancreas. The patient underwent enucleation of the pancreas head lesion. The lesion was confirmed histologically to be focal nesidioblastosis and surgical resection was successfully performed. The patient showed no hypoglycemic symptoms postoperatively.

Keyword

Diabetes mellitus; Nesidioblastosis; Hypoglycemia

MeSH Terms

Calcium
Diabetes Mellitus
Diabetes Mellitus, Type 2
Diazoxide
Head
Humans
Hypoglycemia
Middle Aged
Nesidioblastosis
Pancreas
Prednisolone
Calcium
Diazoxide
Prednisolone

Figure

• 

  Fig. 1 Pancreas MRI showed no abnormal finding.

• 

  Fig. 2 Celiac angiography showed no abnormal finding.

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  Fig. 3 Pancreas pathology. A. A slight increase in endocrine cell aggregates with nuclear pleomorphism randomly distributed in the pancreas. (H&E, ×200). B. Most endocrine cells in enlarged cell aggregates are positive for insulin immunohistochemical stains. (×200).

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