A case with insulinoma is reported, with initial malignant degeneration, diagnosed and operated 16 years ago. Six years later hypoglycemic attaks appeared again and lymph metastasis in good health a third surgical operation was performed because of repeated hypoglycemic attacks and a new metastasis from the insulinoma was found in the pancreas tail. The patients has no hypoglycemic phemonena 18 months after the last operation. Besides the long period of progress of the malignant degenerated insulinoma, not observed so far, certain peculiarities of the carbohydrate metabolism of that patient are stressed upon as well as the necessity of early diagnosis and timely surgical treatment of insulinoma.

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