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Given that the symptoms were similar to an insulin overdose, the patient wanted his \u201cspontaneous hyperinsulinism\u201d evaluated. The dedicated team of R.M. Wilder, F.N. Allan, M.H. Power and H.E. Robertson investigated of Langerhans. Upon surgical exploration by Dr. W.J.Mayo, the body and tail of the pancreas were found to have multiple tumors, and there were liver metastases. The disease was unresectable, and the patient died one month after surgery. Pathology revealed the tumor cells to be consistent with carcinoma of the Islets of Langerhans. Extracts dervied from the liver metastases lowered blood glucose in rabbits, proving the metastases were from the insulin-producing carcinoma. Thus, Wilders, et al. published the first report of an insulinoma in 1927. One century later, insulinomas remain fascinating and challenging. In commemoration of one century of insulinoma-related clinical and basic research, this narrative review describes key breakthroughs and presents, by means of seven case studies, the clinical spectrum of insulinomas and their clinical courses, from benign to fatally malignant.<\/jats:p>","DOI":"10.1007\/s11154-026-10077-y","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T03:24:16Z","timestamp":1787714656000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Shades of insulinoma one century after first extensive evaluation by Wilder and colleagues; a figurative review between light and dark"],"prefix":"10.1007","author":[{"given":"Dieter","family":"H\u00f6rsch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Fijalkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Peter-Stein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zinica","family":"Chiorean","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Daffner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kaemmerer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birger","family":"Mensel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Meister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekkehard","family":"Eigendorff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Anlauf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Will","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Petrovitch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Costello-Boerrigter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almut","family":"Kunze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard P.","family":"Baum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Langbein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merten","family":"Hommann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"10077_CR1","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1001\/jama.1927.02690050014007","volume":"89","author":"RM Wilder","year":"1927","unstructured":"Wilder RM, Allan FN, Power MH, Robertson HE. 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R.F. declares no conflict of interests (ORCID 0009-0007-4576-8629). J.P.-S. declares no conflict of interests (0000-0002-8845-3199). W.D. declares no conflict of interests (ORCID 0009-0007-1828-0855). D.K. declares travel support from Ipsen (ORCID 0000-0002-7475-1259). B.M. declares no competing interests (ORCID 0009-0005-5941-5862). J.M. declares fees for lectures from Novartis (ORCID : 0009-0002-9919-9832). E.E. declares no conflict of interests (ORCID 0009-0006-3804-7447). M.A. declares no conflict of interest (ORCID 0000-0004-6326-019X). U.W. declares no conflicts of interest (ORCID 0009-0004-6326-019X). A.P. declares no conflicts of interest (ORCID 0000-0002-7513-9547). L.C.-B. declares no conflicts of interest (ORCID 0000-0002-6534-1629). A.K. declares no conflicts of interest (ORCID 0009-0006-4441-9825). T.L. declares fees from rom Blue Earth Diagnostics Ltd (consultant, research funding), Novartis (consultant, speaker) and ITM (speaker) (ORCID 0000-0003-4258-5687). R.P.B. is an advisor \/ Consultant to 3B Pharmaceuticals, ITM, Perspective Therapeutics, and Telix Pharmaceuticals. He is founder\/co-founder of RadioVaxx, NucleoGenesis, and ZENTA. He is member of the ICPO Board of Trustees, and President of the ICPO Academy (no payments). M.H. declares no conflict of interest (ORCID 0009-0008-1512-4424).","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}