• Masato Yoshioka, Satoshi Shibata, Hiroshi Uchinami, Go Watanabe, Hideaki Miyazawa, Masatake Iida, Makoto Yoshida, Toshiaki Yoshioka, Hiroshi Nanjo, and Yuzo Yamamoto.
• Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Japan.
• Intern. Med. 2015 Jan 1; 54 (7): 785790785-90.

AbstractWe 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.

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