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February 16, 1946

Clinical Notes, Suggestions and New Instruments

JAMA. 1946;130(7):404-406. doi:10.1001/jama.1946.02870070024007

HYPOGLYCEMIA DUE TO INSULAR ADENOMA OF PANCREAS  HARRY E. ISAACS, M.D. Attending Surgeon, Beth Israel Hospital New YorkHyperinsulinism1 is most frequently caused by a benign adenoma of the beta cells of the islands of Langerhans or by a carcinoma of the islet cells.2 If the suspected adenoma can be found, the treatment is simple and effective—the malignant group requires radical resection of the pancreas and duodenum with a prognosis as different as is the procedure. It seems advisable to separate these widely divergent lesions and group their reports under the title of the causative lesion rather than under the symptom which may be produced. A review of all cases of benign adenomas has been brought up to January 1944,3 127 in number, which includes Whipple's4 listing of 103 adenomas in a series of 160 cases of islet tumors. In this report there are 27 cases of hyperinsulinemia due to carcinoma and 22 of suspected carcinoma, 49 cases out of a total of 176,

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