title: The transformation of a nonfunctioning islet cell tumor of the pancreas into a proinsulinoma under conditions of lung metastasis.
abstract: We herein report the first case of a nonfunctioning islet cell tumor that transformed into a proinsulinoma during the process of metastasis to the lungs. This phenomenon was confirmed in a 69-year-old woman with an advanced pancreatic islet cell tumor and multiple liver metastases who later developed multiple lung metastases. She underwent pancreatic resection followed by the administration of chemotherapy and survived for seven years. Although the patient initially had hyperglycemia due to diabetes mellitus, she conversely began to manifest hypoglycemic attacks 63 months postoperatively with the concomitant development of multiple lung metastases. An autopsy revealed that only the tumor in the lungs produced proinsulin; no other hormones were detected.
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Yoshioka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shibata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uchinami
authors.forename: Go
authors.initials: G
authors.lastname: Watanabe
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyazawa
authors.forename: Masatake
authors.initials: M
authors.lastname: Iida
authors.forename: Makoto
authors.initials: M
authors.lastname: Yoshida
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yoshioka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nanjo
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018273:Carcinoma, Islet Cell / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D003082:Colectomy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003981:Diazoxide / Q000008:administration & dosage; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005743:Gastrectomy; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000517:prevention & control*; D008175:Lung Neoplasms / Q000556:secondary* / Q000628:therapy; D016685:Mitomycin / Q000008:administration & dosage; D009392:Nephrectomy; D015282:Octreotide / Q000008:administration & dosage; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D000093542:Gemcitabine
chemical_list: D018931:Antineoplastic Agents, Hormonal; D003841:Deoxycytidine; D016685:Mitomycin; D003981:Diazoxide; D015282:Octreotide; D005472:Fluorouracil; D000093542:Gemcitabine