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Case Reports
. 2022 Oct 7:2022:2802975.
doi: 10.1155/2022/2802975. eCollection 2022.

Functional Localization of Adult-Onset Idiopathic Nesidioblastosis

Jess C Hercus  1 , Pouneh Pasha  2 , Sadiq Al Lawati  3 , Peter Kim  4 , Andre Mattman  5 , Douglas Webber  5 , David M Thompson  3
Affiliations
Case Reports

Functional Localization of Adult-Onset Idiopathic Nesidioblastosis

Jess C Hercus et al. Case Rep Endocrinol. .

Abstract

Nesidioblastosis is a rare pancreatic disorder involving enlarged beta cells throughout the pancreas, causing elevated insulin production. We present the case of a 53-year-old woman with the initial symptom of fasting hypoglycemia. No pancreatic lesions were indicated on computed tomography and magnetic resonance imaging scans, and an octreotide scan was negative for insulinoma. Selective arterial calcium stimulation (SACST) showed increased insulin production from the stimulation of 3 out of 5 arteries. The SACST results suggested a diagnosis of nesidioblastosis, which was confirmed by histopathology after a subtotal distal pancreatectomy. The patient has normal glucose tolerance after surgery with no further problems of hypoglycemia, indicating that this is a rare case of nesidioblastosis extending only partially through the pancreas.

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Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this article.

Figures

Figure 1
Figure 1
Pancreatic parenchyma at 100× magnification, with arrows indicating enlarged islets.
Figure 2
Figure 2
Islet cells at 200× magnification, with arrow indicating an enlarged nucleus.
See this image and copyright information in PMC

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