A CASE OF MEN TYPE I INSULINOMA AND REVIEW OF THE JAPANESE LITERATURE

A case of insulinoma complicated with parathyroidal hyperplasia and duodenal carcinoid, generally designated multiple endocrine neoplasia (MEN) type I, is presented. A 48-year-old man was admitted with a chief complaint of hypoglycemic attack, and was diagnosed as having pancreas insulinoma on abdominal CT, celiac angiogram, and various provocative tests. He had undergone subtotal parathyroidectomy one year before, and the histologic examination had shown hyperplasia. On fiberscopic examination, a small tumor was found at the second portion of the duodenum, and it was histologically diagnosed as carcinoid. On operation, three daughter tumors of the insulinoma were found in the body of the pancreas. Thus, distal pancreatectomy, extirpation of the daughter tumors and excision of the duodenal carcinoid were undertaken. We also reviewed MEN type I cases complicated with insulinoma as a pancretic tumor reported in Japan up to 1985.