Insulin Secreting Islet Cell Tumors of the Pancreas

FUNCTIONING islet tumors of the pancreas producing spontaneous hypoglycemia have been studied with interest at McGill University since the original report from the Pathological Institute by Nicholls¹ in 1902. In 1927, Wilder et al² demonstrated the relationship between hyperinsulinism and a malignant islet cell tumor by means of bioassay of the metastasis for insulin. Two years later, Roscoe Graham removed a benign functioning insulinoma, producing relief of symptoms; there was no recurrence when the patient was studied ten years later.^3,4

Whipple and Franz⁵ reported six cases in 1935 and established diagnostic criteria. There must be lack of relief by low carbohydrate diet in order to exclude functional hypoglycemia so far as possible.⁶

The pathology of insulinomas was extensively reviewed by Duff⁷ following the report by Nicholls, and also by Franz.⁸ Howard et al⁶ reported, in 1950, a collected series of 398 islet