{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:00:17Z","timestamp":1791489617483,"version":"4.3.4"},"reference-count":7,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Key Clinical Message<\/jats:title>\n                    <jats:p>This case highlights the possibility of an insulinoma expressing an aberrant form of SSTRs resulting in a discrepancy between the preoperative octreotide assessment and postoperative SSTR expression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>\n                      Insulinoma is a pancreatic disease that causes hyperinsulinemic hypoglycemia. The first\u2010line treatment is surgery; however, somatostatin derivatives are administered in cases where surgery is not a viable option and to prevent preoperative hypoglycemia. Here, we report a case in which preoperative examination indicated a potential tumor with low somatostatin receptor 2 (SSTR2) and SSTR5 expression, whereas postoperative pathological examination indicated strong SSTR expression. We report the case of a 69\u2010year\u2010old Japanese female who experienced hypoglycemia\u2010like symptoms for a decade such as sweating, fatigue, hunger, and confusion with an increase in episode frequency per year. Dynamic computed tomography revealed a 13\u2010mm diameter nodule and aberrant blood flow in the pancreatic tail. Subsequently, the patient was diagnosed with pancreatic insulinoma. A preoperative octreotide test did not relieve hypoglycemia, and no uptake of\n                      <jats:sup>111<\/jats:sup>\n                      indium\u2010pentetreotide was observed, suggesting an insulinoma with low SSTR expression. However, postoperative histological studies suggested that the intracellular domain of SSTRs were highly expressed, while the extracellular domain may be mutated. We present a rare case of insulinoma expressing an aberrant form of SSTRs resulting in a discrepancy between the preoperative octreotide assessment and postoperative SSTR expression.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccr3.9390","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T22:59:47Z","timestamp":1730847587000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Insulinoma with suspected mutant somatostatin receptor expression according to histological examination"],"prefix":"10.1002","volume":"12","author":[{"given":"Shunichiro","family":"Onish","sequence":"first","affiliation":[{"name":"Department of Diabetes, Metabolism, and Endocrinology International University of Health and Welfare, Narita Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aki","family":"Takada\u2010Watanabe","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hematology and Gerontology Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Y.","family":"Osamura","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Nippon Koukan Hospital  Kawasaki City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4250-1204","authenticated-orcid":false,"given":"Takayuki","family":"Shiomi","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology International University of Health and Welfare, Narita Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Kusano","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology International University of Health and Welfare, Narita Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiro","family":"Maezawa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hematology and Gerontology Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Murai","sequence":"additional","affiliation":[{"name":"Department of Neurology International University of Health and Welfare, Narita Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Miyabayashi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hematology and Gerontology Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakutaro","family":"Koike","sequence":"additional","affiliation":[{"name":"School of Medicine International University of Health and Welfare  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Metabolism, and Endocrinology International University of Health and Welfare, Narita Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2343-0788","authenticated-orcid":false,"given":"Minoru","family":"Takemoto","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Metabolism, and Endocrinology International University of Health and Welfare, Narita Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042018820965068"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ15-0371"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3800954"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/en.2011-1662"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-021-01139-2"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.01901"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-016-0768-4"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.9390","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T14:45:32Z","timestamp":1764254732000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.9390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":7,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1002\/ccr3.9390"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.9390","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11]]},"assertion":[{"value":"2024-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e9390"}}