, Volume 15, Issue 9, pp 725-731
Date: 05 Mar 2013

Management of malignant insulinoma

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Abstract

Aim

Malignant insulinoma is an infrequent functional endocrine tumor of the pancreas. Adequate therapy is a demanding challenge for oncologists and endocrinologists.

Objective

To evaluate the results of multidisciplinary management of malignant insulinoma.

Materials and methods

Retrospective review of patients with malignant insulinoma treated from 1995 to 2011.

Results

Seven patients with malignant insulinoma were included: four males and three females; median age was 61.8 years (range 37–78). Six tumors were sporadic and one was diagnosed in a patient with a type 1 multiple endocrine neoplasia (MEN-1). Surgery was performed in six cases and one patient was considered unresectable. Hypoglycemias persisted in all cases and somatostatin analogs, glucocorticoids and diazoxide were used. Two patients received everolimus. Other techniques were chemoembolization and internal radiation therapy with yttrium-90. Successful liver transplant was done in the patient with MEN-1.

Conclusion

Hypoglycemia management is complex and requires multiple therapies. Further evaluations will be necessary to determine the best treatment.