Endocrine Abstracts

Neuroendocrine tumors are rare in young patients and usually have favorable course. We present a case of young, 13-year-old girl diagnosed with insulinoma. The diagnosis was stated on the basis of the presence of neuroglycopenic symptoms. An abdominal CT scan demonstrated a tumor localized in the head of pancreas. The patient received diazoxide as a preparation to surgery. Therapy was effective, but discontinued due to side effects. Patient underwent the Whipple operation. During this surgery pathological local lymph nodes and liver metastases were also stated. Histopathological examination confirmed well differentiated neuroendocrine tumor WHO grade1 with Ki67 index <1%. Hypoglycemia persists after surgery. Four months after operation liver metastases grew up to 28 mm dimension and pathological lymph nodes were observed. PET–FDG was negative whereas PET-Ga68-DOTATATE was positive (about half of known disease foci showed tracer uptake). Despite the fact of only partially positive PET we decided to introduce somatostatin analogue into the treatment of hypoglycemia. The patient continues therapy with a very good control of glycemia. In the case of disease progression systemic therapy will be considered.

The presented case is an example of unfavorable course of rare neoplastic disease in young patient.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.