Robotic enucleation for pediatric insulinoma with MEN1 syndrome: a case report and literature review

BMC Surg. 2018 Jun 19;18(1):44. doi: 10.1186/s12893-018-0376-5.

Abstract

Background: A patient with a rare pediatric insulinoma and MEN1 syndrome was treated by robotic enucleation surgery.

Case presentation: We present a case of a 9-year-old girl presenting with repeated loss of consciousness, concomitant with a pale face, palpitations, and convulsions, which had persisted for 2 years and had been aggravated during the previous 2 months. She was previously misdiagnosed with epilepsy in another hospital. We further examined her while she was hospitalized. By combining her medical history and imaging examination and lab test results, a diagnosis of insulinoma was confirmed. Sanger-directed sequencing on a peripheral blood sample revealed an MEN1 gene mutation, indicating pediatric insulinoma with MEN1 syndrome. The patient underwent minimally invasive insulinoma enucleation surgery under the Da Vinci robot-assisted system with intraoperative ultrasound (IOUS) connected. The surgery was successfully completed within 65 min, and the girl recovered well postoperatively and no longer experienced symptoms of hypoglycemia.

Conclusion: This is the first report of a case of pediatric insulinoma treated using robotic enucleation. This experience demonstrates the feasibility and safety of combining robotic surgery with the enucleation procedure as an excellent strategy for pediatric insulinoma.

Keywords: MEN1 syndrome; Pediatric insulinoma; Robotic enucleation; Surgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child
  • Female
  • Humans
  • Insulinoma / surgery*
  • Multiple Endocrine Neoplasia Type 1 / surgery*
  • Pancreatic Neoplasms / surgery
  • Robotic Surgical Procedures / methods*
  • Ultrasonography