{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T19:12:14Z","timestamp":1761765134581},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"797","license":[{"start":{"date-parts":[[1992,3,1]],"date-time":"1992-03-01T00:00:00Z","timestamp":699408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1992,3,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>A 15 year old girl with a family history of type 1 multiple endocrine adenomatosis presented with reversible neurological disturbances, hypoglycaemia and hyperinsulinaemia. Initial radiology was normal, but portal venous sampling suggested an insulinoma in the tail of the pancreas which was removed with conservation of the spleen. Hypoglycaemia persisted despite high doses of diazoxide and intravenous dextrose. A second laparotomy revealed a pancreatic endocrine tumour and sub-total pancreatectomy was performed. Histology revealed islet cell microadenomatosis. Hypoglycaemia persisted despite treatment with somatostatin analogues and 40% intravenous dextrose was required to maintain normoglycaemia. A possible lesion near the splenic hilum on computed tomographic scan was reported as a splenunculus although further peripheral, hepatic and portal venous sampling suggested hepatic or systemic lesions. A positron emission scan and selective visceral angiography suggested a lesion in the left upper quadrant. Acute lactic acidosis, rhabdomyolysis and renal failure supervened. Post mortem revealed the putative 'splenunculus' to be a residual insulinoma, whilst the splenic vein was thrombosed, accounting in part for discrepant venous sampling data.<\/jats:p>\n               <jats:p>Hyperinsulinaemia in type 1 multiple endocrine adenomatosis may require more aggressive surgical and hormonal intervention than when dealing with solitary insulinomas. Insulinomas may mimic developmental abnormalities on computed tomographic scanning.<\/jats:p>","DOI":"10.1136\/pgmj.68.797.196","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T21:01:03Z","timestamp":1230584463000},"page":"196-200","source":"Crossref","is-referenced-by-count":8,"title":["Difficulties in localization and treatment of insulinomas in type 1 multiple endocrine adenomatosis (MEA)"],"prefix":"10.1093","volume":"68","author":[{"given":"Peter H","family":"Winocour","sequence":"first","affiliation":[{"name":"University of Manchester Departments of Medicine, Hope Hospital , Salford"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kieran J","family":"Moriarty","sequence":"additional","affiliation":[{"name":"University of Manchester Departments of Medicine, Hope Hospital , Salford"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C Nicholas","family":"Hales","sequence":"additional","affiliation":[{"name":"University of Cambridge Department of Clinical Biochemistry , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judy","family":"Adams","sequence":"additional","affiliation":[{"name":"University of Manchester Departments of Diagnostic Radiology, Hope Hospital , Salford"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy","family":"Reeve","sequence":"additional","affiliation":[{"name":"University of Manchester Departments of Histopathology, Hope Hospital , Salford"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Wynick","sequence":"additional","affiliation":[{"name":"University Departments of Medicine, Hammersmith Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Allison","sequence":"additional","affiliation":[{"name":"University Departments of Diagnostic Radiology, Hammersmith Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven R","family":"Bloom","sequence":"additional","affiliation":[{"name":"University Departments of Medicine, Hammersmith Hospital , London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C","family":"Anderson","sequence":"additional","affiliation":[{"name":"University of Manchester Departments of Medicine, Hope Hospital , Salford"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1992,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/B978-0-407-02317-8.50012-4","article-title":"Insulin tumours of the pancreas","volume-title":"Endocrine Surgery","author":"Le Quesne, L.P.; Daggett, P.R.","year":"1983","unstructured":"Le Quesne, L.P. & Daggett, P.R. Insulin tumours of the pancreas. In: Johnston, I.D.A. & Thompson, N.W. (eds) Endocrine Surgery. Butterworth, London, 1983, pp. 104-124."},{"issue":"207","key":"ref_2","first-page":"1679","article-title":"Nesidioblastosis in familial endocrine adenomatosis","volume":"1969","author":"Vance, J.E.; Stoll, R.W.; Kitabachi, A.E.","unstructured":"Vance, J.E., Stoll, R.W., Kitabachi, A.E. et al. Nesidioblastosis in familial endocrine adenomatosis. JAMA 1969, 207: 1679.","journal-title":"JAMA"},{"key":"ref_3","first-page":"2","article-title":"Multiple endocrine neoplasia syndromes","volume":"1984","author":"Lips, C.J.; Vasen, H.F.; Lamers, C.B.","unstructured":"Lips, C.J., Vasen, H.F. & Lamers, C.B. Multiple endocrine neoplasia syndromes. Crit Rev Oncol Haematol 1984, 2: 117-184.","journal-title":"Crit Rev Oncol Haematol"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1042\/bj2600535","article-title":"Sensitive and specific two-site immunoradiometric assays for human insulin, proinsulin, 65-66 split and 32-33 split proinsulins","volume":"260","author":"Sobey, W.J.; Beer, S.F.; Carrington, C.A.","year":"1989","unstructured":"Sobey, W.J., Beer, S.F., Carrington, C.A. et al. Sensitive and specific two-site immunoradiometric assays for human insulin, proinsulin, 65-66 split and 32-33 split proinsulins. Biochem J 1989, 260: 535-541.","journal-title":"Biochem J"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101","DOI":"10.7326\/0003-4819-79-1-101","article-title":"Pancreatic islet cell carcinoma. Clinical features of 52 patients","volume":"79","author":"Broder, L.E.; Carter, S.K.","year":"1973","unstructured":"Broder, L.E. & Carter, S.K. Pancreatic islet cell carcinoma. Clinical features of 52 patients. Ann Int Med 1973, 79, 101-107.","journal-title":"Ann Int Med"},{"key":"ref_6","first-page":"597","article-title":"Beta-islet cell tumours of the pancreas: Results on a study of 1067 cases","volume":"75","author":"Stefanini, P.; Carboni, M.; Patrassi, N.","year":"1974","unstructured":"Stefanini, P., Carboni, M., Patrassi, N. et al. Beta-islet cell tumours of the pancreas: Results on a study of 1067 cases. Surgery 1974, 75: 597-609.","journal-title":"Surgery"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"162","DOI":"10.7326\/0003-4819-107-2-162","article-title":"Treatment of metastatic islet cell carcinoma with a somatostatin analogue (SMS-201-995)","volume":"107","author":"Kvols, K.L.; Buck, M.; Moertel, C.G.","year":"1987","unstructured":"Kvols, K.L., Buck, M., Moertel, C.G. et al. Treatment of metastatic islet cell carcinoma with a somatostatin analogue (SMS-201-995). Ann Intern Med 1987, 107: 162-168.","journal-title":"Ann Intern Med"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/B978-0-407-02317-8.50014-8","article-title":"Surgical considerations in the MEA type 1 syndrome","volume-title":"Endocrine Surgery","author":"Thompson, N.W.","year":"1983","unstructured":"Thompson, N.W. Surgical considerations in the MEA type 1 syndrome. In: Johnston, I.D.A. & Thompson, N.W. (eds) Endocrine Surgery. Butterworths, London, 1983, pp. 151-161."},{"issue":"20","key":"ref_9","first-page":"7","article-title":"Multiple endocrine syndromes - a nightmare for the endocrinologic radiologist","volume":"1985","author":"Doppman, J.L.","unstructured":"Doppman, J.L. Multiple endocrine syndromes - a nightmare for the endocrinologic radiologist. Sem Roentg 1985, 20: 7-16.","journal-title":"Sem Roentg"},{"key":"ref_10","first-page":"764","article-title":"Suppression of pancreatic endocrine tumour secretion by long-acting somatostatin analogue","volume":"2","author":"Lang, R.G.; Barnes, A.J.; Adrian, T.E.","year":"1979","unstructured":"Lang, R.G., Barnes, A.J., Adrian, T.E. et al. Suppression of pancreatic endocrine tumour secretion by long-acting somatostatin analogue. Lancet 1979, 2: 764-767.","journal-title":"Lancet"},{"key":"ref_11","first-page":"577","article-title":"Chronic treatment of gut hormone producing tumours (apudomas) with a long-acting somatostatin analogue","volume":"28","author":"Chung, J.H.; Williams, S.J.; Bloom, S.R.","year":"1983","unstructured":"Chung, J.H., Williams, S.J. & Bloom, S.R. Chronic treatment of gut hormone producing tumours (apudomas) with a long-acting somatostatin analogue. Dig Dis Sci 1983, 28: 577-584.","journal-title":"Dig Dis Sci"},{"issue":"26","key":"ref_12","first-page":"433","article-title":"New somatostatin molecule for management of endocrine tumours","volume":"1985","author":"Bonfils, S.","unstructured":"Bonfils, S. New somatostatin molecule for management of endocrine tumours. Gut 1985, 26: 433-437.","journal-title":"Gut"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/68\/797\/196\/50074075\/postgradmedj-68-196.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/68\/797\/196\/50074075\/postgradmedj-68-196.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T14:56:58Z","timestamp":1682607418000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/68\/797\/196\/7062283"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,3,1]]},"references-count":12,"journal-issue":{"issue":"797","published-online":{"date-parts":[[1992,3,1]]},"published-print":{"date-parts":[[1992,3,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.68.797.196","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1992,3]]},"published":{"date-parts":[[1992,3,1]]}}}