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Embolization as an Alternative Treatment of Insulinoma in a Patient with Multiple Endocrine Neoplasia Type 1 Syndrome

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Abstract

Insulinoma is a rare neuroendocrine tumor, most commonly originating from the pancreas, which is either sporadic or familial as a component of multiple endocrine neoplasia type 1 syndrome (MEN1). It is characterized by increased insulin secretion leading to hypoglycemia. Surgical removal is considered the treatment of choice, with limited side effects and relatively low morbidity and mortality, both being improved by the laparoscopic procedure. We present the case of a 30-year-old patient with MEN1 and recurrent insulinoma with severe hypoglycemic episodes who could not be surgically treated due to the adherence of the tumor to large blood vessels and to prior multiple surgical operations. He was treated by repeated embolization using spherical polyvinyl alcohol particles, resulting in shrinkage of the tumor, improvement of the frequency and severity of the hypoglycemic episodes, and better quality of life.

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Acknowledgments

We are grateful to the Research Nurse Coordinator Mrs. Vasiliki Fragaki for her valuable assistance in the evaluation of the patient.

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Authors and Affiliations

  1. Endocrine Unit, Second Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, Athens University Medical School, “Attikon” University Hospital, Athens, Greece

    Melpomeni Peppa, Vasilios Pikounis & Dimitrios Hadjidakis

  2. Second Radiology Department, Athens University Medical School, “Attikon” University Hospital, Athens, Greece

    Εlias Brountzos & Nicolaos Economopoulos

  3. Second Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, Athens University Medical School, “Attikon” University Hospital, Athens, Greece

    Eleni Boutati, Theofanis Economopoulos & Sotirios A. Raptis

  4. Third Surgery Department, Athens University Medical School, “Attikon” University Hospital, Athens, Greece

    Paul Patapis

  5. Hellenic National Diabetes Center (H.N.D.C.), Athens, Greece

    Sotirios A. Raptis

Authors
  1. Melpomeni Peppa
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  2. Εlias Brountzos
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  3. Nicolaos Economopoulos
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  4. Eleni Boutati
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  5. Vasilios Pikounis
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  6. Paul Patapis
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  7. Theofanis Economopoulos
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  8. Sotirios A. Raptis
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  9. Dimitrios Hadjidakis
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Correspondence to Melpomeni Peppa.

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Peppa, M., Brountzos, Ε., Economopoulos, N. et al. Embolization as an Alternative Treatment of Insulinoma in a Patient with Multiple Endocrine Neoplasia Type 1 Syndrome. Cardiovasc Intervent Radiol 32, 807–811 (2009). https://doi.org/10.1007/s00270-008-9499-x

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  • DOI: https://doi.org/10.1007/s00270-008-9499-x

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