BACKGROUND Proinsulinoma is a neuroendocrine tumor (NET) of the pancreas that produces prohormone proinsulin. These tumors are very rare. In the literature, they are most often presented in the form of case reports. MATERIALS AND METHODS We studied 177 patients with NET of the pancreas who underwent surgical treatment in the A.V. Vishnevsky National Medical Research Centre of Surgery from January 2007 to December 2018. RESULTS Of 81 patients with organic hyperinsulinism caused by functioning NETs of the pancreas during the study period, 3 (3.7%) had a proinsulinoma; 2 were female; and 1 was male. None of them admitted to weight gain during this period, and their BMI was normal. All patients presented with Whipple's triad during the 72-h fast. Tumor-enucleating surgery was performed: one robot assisted, two laparotomies. A normal glucose level after treatment was achieved in all cases. CONCLUSION In cases where clinical hypoglycemia is present, but the serum insulin level is within the normal range or even decreased, proinsulinoma should be suspected. For now, surgical resection remains the only effective method of treatment. Further investigation of pro-insulinomas is needed.

中文翻译：

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分泌胰岛素原的胰腺神经内分泌肿瘤：单中心经验。

背景胰岛素原瘤是产生激素原胰岛素原的胰腺神经内分泌肿瘤(NET)。这些肿瘤非常罕见。在文献中，它们最常以病例报告的形式呈现。材料与方法 我们研究了 2007 年 1 月至 2018 年 12 月在 AV Vishnevsky 国家外科医学研究中心接受手术治疗的 177 例胰腺 NET 患者。结果 研究期间 81 例由功能性胰腺 NET 引起的器质性高胰岛素血症患者期间，3 (3.7%) 人患有胰岛素原瘤；2名女性；1是男性。他们都没有承认在此期间体重增加，他们的 BMI 是正常的。所有患者在 72 小时禁食期间出现 Whipple 三联征。进行了肿瘤摘除手术：一台机器人辅助，两次剖腹手术。在所有病例中均达到治疗后的正常葡萄糖水平。结论 临床上出现低血糖，但血清胰岛素水平在正常范围内甚至下降时，应怀疑胰岛素原瘤。目前，手术切除仍然是唯一有效的治疗方法。需要进一步研究前胰岛素瘤。