INSULINOMA IN CHILDHOOD

The case of a 12-year-old girl with an insulinoma is described in detail, and short accounts are given of 4 other children presenting with this condition in the United Kingdom during the past 10 years. The literature has been reviewed, and the sex and age incidence, presenting symptoms and signs, and the nature of the tumour in the 39 children aged less than 15 years are discussed. There have been 9 children aged less than 4 years with insulinomas and, contrary to previous reports, the condition appears to be at least as common in this age-group as in older children. Biochemically, the most useful guide in diagnosis is the detection of raised fasting plasma insulin levels. The therapeutic approach is outlined with reference to the diagnostic problems peculiar to the younger child and despite hypoglycaemic episodes and the risk of brain damage, more than 50% of children with insulinomas made a complete recovery after treatment.