Pediatric Insulinoma

  • Etiology:
    — Develop from ductal pluripotential cells into unregulated cells that secrete insulin
    — Insulin is normally secreted by beta cells of islets of Langerhans
  • Imaging: Small well-defined hypervascular tumors located anywhere in pancreas
  • DDX:
  • Complications:
  • Treatment:
  • Clinical:
    — Present with Whipple’s triad of fasting hypoglycemia and symptoms of hypoglycemia and immediate relief of symptoms after being given IV glucose
    — Have association with multiple endocrine neoplasia type I

Radiology Cases of Insulinoma

MRI of insulinoma
Axial T1 MRI without contrast of the abdomen (above left) shows a small, oval low signal intensity lesion in the tail of the pancreas which is nestled in the splenic hilum. The lesion is high signal intensity on the T2 MRI (above right). T1 MRI with contast in arterial (below left) and venous (below right) phases shows the lesion to fill in over time.