Functioning Adenomas of Pancreas With Hyperinsulinism

Abstract

FUNCTIONING tumors of the pancreas which produce hypoglycemia continue to pose problems in diagnosis and management. The first successful removal of a functioning adenoma by Roscoe Graham in 1929¹⁶ had been preceded by the work of Harris¹³ and Wilder³⁵ which was instrumental in the discovery of this interesting pathophysiologic relationship. Members including Judd,¹⁸ Engel,⁸ Nesselrode,²⁵ and Cheley³ soon reported successful removal of adenomata before this association in 1934. At that same meeting, George Thomason³⁰ reported a patient with symptoms of hyperinsulinism upon whom he had operated and an adenoma was not found. Removal of the tail and body of the pancreas, subsequently found not to contain an adenoma, resulted in improvement for the short three month follow-up. Graham and Hartmann¹² had reported a similar result in a 12-month-old child with hyperinsulinism after a 90% resection of the distal pancreas. These and