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May 1981

Nesidioblastosis in AdultsA Surgical Dilemma

Author Affiliations

From the Departments of Surgery (Drs Harness and Thompson), Pathology (Dr Clark), and Internal Medicine, Division of Endocrinology and Metabolism (Dr Fajans), University of Michigan, Ann Arbor; Department of Surgery (Dr Geelhoed), George Washington University Medical Center, Washington, DC; Department of Surgery (Dr Kraft), St Joseph's Mercy Hospital, Ann Arbor; and Department of Pathology (Drs Nishiyama and Howard), Maine Medical Center, Portland.

Arch Surg. 1981;116(5):575-580. doi:10.1001/archsurg.1981.01380170055010

• Nesidioblastosis is the leading cause of hyperinsulinemia in newborns and infants. To our knowledge, it has not been previously reported in adults unless associated with other diseases. Three males and three females, aged 11 to 57 years, are described. Pancreatic resections ranged from 50% to 100%. Postoperatively, three patients were normoglycemic, two were insulin-dependent diabetics, and one had recurrent hypoglycemia controlled by drugs. The histologic findings in adults were very similar to those in infants with nesidioblastosis. It appears that a minimum resection of 75% to 80% of the pancreas will benefit the majority of patients, alleviating hypoglycemia and preventing the development of diabetes.

(Arch Surg 1981;116:575-580)

Laidlaw GF:  Nesidioblastoma, the islet tumor of the pancreas . Am J Pathol 1938;14:125-139.
Brown RE, Still WJS:  Nesidioblastosis and the Zollinger-Ellison syndrome . Am J Dig Dis 1968;13:656-663.Article
Vance JE, Stoll RW, Kitabchi AE, et al:  Familial nesidioblastosis as the predominant manifestation of multiple endocrine adenomatosis . Am J Med 1972;52:211-227.Article
Grotting JC, Kassel S, Dehner LP:  Nesidioblastosis and congenital neuroblastoma . Arch Pathol Lab Med 1979;103:642-645.
Hull MT, Warfel KA, Muller J, et al:  Familial islet cell tumors in Von Hippel-Lindau's disease . Cancer 1979;44:1523-1526.Article
Kowlessar OD:  Diseases of the pancreas , in Besson PB, McDermott W (eds): Cecil-Loeb Textbook of Medicine , ed 12. Philadelphia, WB Saunders Co, 1967, pp 905-910.
Brown RE, Madge GE:  Cystic fibrosis and nesidioblastosis . Arch Pathol Lab Med 1971;92:53-57.
Stefanini P, Carboni M, Patrassi N, et al:  Beta-islet cell tumors of the pancreas: Results of a study on 1,067 cases . Surgery 1974;75:597-609.
Shermeta DW, Mendelsohn G, Haller JA:  Hyperinsulinemic hypoglycemia of the neonate associated with persistent fetal histology and function of the pancreas . Ann Surg 1980;191:182-186.Article
Jaffe R, Hashida Y, Yunis EJ:  Pancreatic pathology in hyperinsulinemic hypoglycemia of infancy . Lab Invest 1980;42:356-365.
Taylor CR:  Immunoperoxidase techniques: Theoretical and pancreatical aspects . Arch Pathol Lab Med 1978;102:113-121.
Edis AJ, Mcllrath DC, van Heerden JA, et al:  Insulinoma: Current diagnosis and surgical management . Curr Probl Surg 1976;13:1-45.Article
Bradley JR, Heileman JP:  Hyperinsulinism due to pancreatic islet cell hyperplasia: Report of a case in an adult . Ariz Med 1976;33:543-545.
Whipple AO, Frantz VK:  Adenoma of islet cells with hyperinsulinism . Ann Surg 1935;101:1299-1327.Article
Shatney CH, Grage TB:  Diagnostic and surgical aspects of insulinoma: A review of 27 cases . Am J Surg 1974;127:174-184.Article
LeQuesne LP, Nabarro JDN, Kurtz A, et al:  The management of insulin tumors of the pancreas . Br J Surg 1979;66:373-378.Article
Howard JM, Moss WH, Rhoades JE:  Hyperinsulinism and islet cell tumors of the pancreas . Surg Gynecol Obstet 1950;90:417-455.
Kavlie H, White TT:  Pancreatic islet beta cell tumors and hyperplasia: Experience in 14 Seattle hospitals . Ann Surg 1972;175:326-335.Article