ArticleWorld journal of surgery2009
Multiple proinsulin-secreting tumors of the pancreas treated by laparoscopic distal pancreatectomy and splenectomy.
Article in World journal of surgery, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.
- A Systematic Review of Proinsulin-Secreting Pancreatic Neuroendocrine Tumors.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Pooled it
- Guideline
- Proinsulin-Secreting Neuroendocrine Tumors of the Pancreas: A Single-Centre Experience.Gastrointestinal tumors · 2019Article
- Recurrence of Metastatic Pro-insulinoma Nearly 50 Years After Subtotal Pancreatectomy.Journal of gastrointestinal cancer · 2019Article
- Hypoglycemic syndrome in a patient with proinsulin-only secreting pancreatic adenoma (proinsulinoma).Case reports in medicine · 2011Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with pancreatic tumors that induce hypoglycemia present with a myriad of symptoms. Laboratory testing can frequently result in data challenging to the clinician to confirm the biochemical diagnosis. Proinsulin, in addition to insulin levels, may be essential in evaluating and diagnosing an insulinoma.
methodsThe objective of this case report is to demonstrate the potential importance of proinsulin levels in the evaluation of tumor-induced hypoglycemia. We report a 49-year-old woman with an unusual clinical presentation. Unlike many patients with tumor-induced hypoglycemia, her fasting glucose levels were fairly unimpressive, her insulin levels were undetectable during a prolonged fast, and she had elevated proinsulin levels.
resultsThe inpatient fast was remarkable for levels of serum glucose 53 mg/dl or higher, a serum insulin <2 uIU/ml, C-peptide 0.7-1.1 (nl 0.8-3.1 ng/ml), and proinsulin 29.2-36.8 pmol/l (nl < or = 18.8 pmol/l). CT scanning of the abdomen revealed multiple pancreatic lesions. A laparoscopic distal pancreatectomy led to the removal of multiple neuroendocrine tumors, which stained only for proinsulin and not for other pancreatic tumor markers. Postoperatively, she normalized her biochemical serum studies and has remained symptom-free 2 years later.
conclusionsThe measurement of proinsulin plays an important part in the diagnostic workup of neuroendocrine tumors causing hypoglycemia. These potentially malignant tumors can be treated adequately with minimally invasive surgery.
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