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Malignant insulinoma with metastasis to gallbladder and bone, accompanied by past history of peptic ulcer and hyperthyroidism

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Summary

A case of a malignant insulinoma in a 53-year-old female is presented. In 1973, the patient underwent caudal pancreatectomy for a malignant insulinoma. Ten years later, it was discovered that the insulinoma had spread to the bones. On admission for cholecystectomy because of a gallbladder polyp and gallstones, she often experienced hypoglycemic attacks, and both calcium and glucagon provocation tests elicited marked release of insulin. Selective angiography of the common hepatic artery showed a tumor blush near the hilum of the liver. Immunohistochemical staining of the gallbladder polyp and the bone tumors proved positive for insulin. Plasma levels of insulin and prolactin were abnormally high. The patient had also been treated for a perforated duodenal ulcer and hyperthyroidism. It is concluded that this may have been a case of a multiple endocrine neoplasia.

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References

  1. Larsson L-I: Classification of pancreatic endocrine tumours. Scand J Gastroenterol 14(Suppl 53):15–18, 1978

    Google Scholar 

  2. Stefanini P, Carboni M, Patrassi N, Basoli A: Beta-islet cell tumors of the pancreas: Results of a study on 1067 cases. Surgery 75:597–609, 1974

    Google Scholar 

  3. Kurayama H, Okazaki M, Tajima N, Muto K, Ikeguchi S, Shida S, Miyao M, Yoshimura M: Insulinoma: A case report. J Jpn Soc Clin Surg 46:410–415, 1985

    Google Scholar 

  4. Creutzfeldt W: Endocrine tumors of the pancreas: Clinical, chemical, and morphologic findings.In The Pancreas. PJ Fitzgerald, AB Morrison (eds). Baltimore, Williams & Wilkins, 1980, pp 208–230

    Google Scholar 

  5. Welbourn RB, Wood SM, Polak JM, Bloom SR: Pancreatic endocrine tumours.In Gut Hormones. SR Bloom, JM Polak (eds). Edinburgh, Churchill Livingstone, 1981, pp 547–554

    Google Scholar 

  6. Pearse AG, Polak JM: Neural crest origin of the endocrine polypeptide (APUD) cells of the gastrointestinal tract and pancreas. Gut 12:783–788, 1971

    Google Scholar 

  7. Townsend CM Jr, Thompson JC: Surgical management of tumors that produce gastrointestinal hormones. Annu Rev Med 36:111–124, 1985

    Google Scholar 

  8. Heitz, PU, Kasper M, Polak JM, Klöppel G: Pancreatic endocrine tumors: Immunocytochemical analysis of 125 tumors. Hum Pathol 13:263–271, 1982

    Google Scholar 

  9. Liu T-H, Tseng H-C, Zhu Y, Zhong S-X, Chen J, Cui Q-C: Insulinoma: An immunocytochemical and morphologic analysis of 95 cases. Cancer 56:1420–1429, 1985

    Google Scholar 

  10. Wermer P: Genetic aspects of adenomatosis of endocrine glands. Am J Med 16:363–371, 1954

    Google Scholar 

  11. Majewski JT, Wilson SD: The MEA-1 syndrome: An all or none phenomenon? Surgery 86:475–484, 1979

    Google Scholar 

  12. Sato T, Imamura M, Sasaki I, Ohneda A: Gastric acid secretion and gastrin and gastric inhibitory polypeptide release in cirrhotic patients. Am J Gastroenterol 80:163–169, 1985

    Google Scholar 

  13. Brunt LM, Dilley WG, Farndon JR, Leight GS, Santen RJ, Veldhuis JD, Wells SA Jr: Evaluation of calcium as an insulin secretagogue in patients with insulinoma. Surg Forum 35:49–52, 1984

    Google Scholar 

  14. Eroder LE, Carter SK: Pancreatic islet cell carcinoma. 1. Clinical features of 52 patients. Ann Intern Med 79:101–107, 1973

    Google Scholar 

  15. Hammer S, Sale G: Multiple hormone producing islet cell carcinomas of the pancreas. Hum Pathol 6:349–362, 1975

    Google Scholar 

  16. Thompson NW, Vinik AI, Eckhauser FE, Strodel WE: Extrapancreatic gastrinoma. Surgery 98:1113–1120, 1985

    Google Scholar 

  17. Becker HD, Reeder DD, Thompson JC: Effect of glucagon on circulating gastrin. Gastroenterology 65:28–35, 1973

    Google Scholar 

  18. Prosser PR, Karam JH, Townsend JJ, Forsham PH: Prolactin-secreting pituitary adenomas in multiple endocrine adenomatosis, type 1. Ann Intern Med 91:41–44, 1979

    Google Scholar 

  19. Berg B, Björklund A, Grimelius L, Ingemansson S, Larsson L-I, Stenram U, Åkerman M: A new pattern of multiple endocrine adenomatasis. Acta Med Scand 200:321–326, 1976

    Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Tohoku University School of Medicine, 1-1 Seiryocho, 980, Sendai, Japan

    Mikio Imamura MD, Eishi Miyashita MD, Kikuo Miyagawa MD, Seiki Matsuno MD & Toshio Sato MD, FACS, FACG

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  1. Mikio Imamura MD
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  2. Eishi Miyashita MD
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  3. Kikuo Miyagawa MD
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  4. Seiki Matsuno MD
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  5. Toshio Sato MD, FACS, FACG
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Imamura, M., Miyashita, E., Miyagawa, K. et al. Malignant insulinoma with metastasis to gallbladder and bone, accompanied by past history of peptic ulcer and hyperthyroidism. Digest Dis Sci 32, 1319–1324 (1987). https://doi.org/10.1007/BF01296384

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  • DOI: https://doi.org/10.1007/BF01296384

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