Langerhans in 1869 first described the pancreatic islets. Fifty-five years later came the monumental discovery of insulin by Banting and Best. Three years later, in 1927, Wilder and his associates6 reported the first case of hyperinsulinism associated with an islet-cell adenoma. Roscoe Graham in 1929 performed the first recorded surgical cure of this disease. In 1950 Howard, Moss, and Rhoads4 analyzed 224 operative cases collected from the world's literature. Conn and Seltzer3 in 1955 presented an excellent review and etiologic classification of spontaneous hypoglycemia—organic and functional. Our report presents an additional interesting case of functioning islet-cell adenoma and emphasizes some important clinical and technical points in the surgery of this tumor.
The patient was a 29-year-old white housewife admitted to the Albert Einstein Medical Center, Southern Division, on July 25, 1958, complaining of "fainting spells" three months prior to admission. The first "attack" preceded breakfast after arising,