Abstract

MYERS ESMENJAUD, Jorge Andrés et al. Nesidioblastosis of the adult, a rare entity for the general surgeon. Cir. gen [online]. 2021, vol.43, n.3, pp.193-197.  Epub June 02, 2023. ISSN 1405-0099.  https://doi.org/10.35366/108573.

Nesidioblastosis is a rare pathology of the endocrine pancreas that causes hypoglycemia due to endogenous hyperinsulinism. It is a hyperplasia of the islets of Langerhans with a hypertrophy of the βeta cells. Treatment options in most cases are distal pancreatectomy. A 64-year-old male with multiple long-term hypoglycemic events. A diagnostic protocol was performed, evidencing the suggestive presence related to insulinoma. It is decided to perform distal pancreatectomy by laparoscopy. A pancreatic fragment with pancreatic islet hyperplasia and isolated endocrine cells was reported. In immunohistochemistry with positivity for synaptophysin and chromogranin confirming the diagnosis of diffuse nesidioblastosis. The patient was discharged without complications and with adequate metabolic control and without episodes of hypoglycemia. This is how nesidioblastosis represents a diagnostic challenge in the patient with hyper insulinemic hypoglycemia refractory to medical management.

Keywords : Nesidioblastosis; hypoglycemia; laparoscopy; distal pancreatectomy; hyperinsulinism; insulinoma.

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