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[Selective therapeutic embolization in malignant insulinoma].

M Civera Andrés1, J T Real Collado, I Martínez Usó

  • 1Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia.

Revista Clinica Espanola
|January 12, 2001
PubMed
Summary

Malignant insulinoma with liver metastases caused severe hypoglycemia. Selective hepatic artery embolization effectively controlled episodes when other treatments failed, offering a new therapeutic option.

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Area of Science:

  • Endocrinology
  • Oncology
  • Interventional Radiology

Background:

  • Malignant insulinoma, a rare tumor, can cause life-threatening hypoglycemia due to excessive insulin secretion.
  • Metastatic spread to the liver complicates management and necessitates multimodal therapeutic approaches.

Observation:

  • A patient with metastatic malignant insulinoma experienced recurrent hypoglycemia refractory to diet, octreotide, and diazoxide.
  • Chemotherapy with adriamycin and streptozotocin failed to reduce tumor size.
  • Selective embolization of the right hepatic artery was performed.

Findings:

  • Following hepatic artery embolization, the patient remained free of hypoglycemic episodes for 14 months.
  • This intervention demonstrated significant efficacy in managing refractory hypoglycemia.

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Implications:

  • Selective hepatic embolization presents a viable therapeutic strategy for controlling hypoglycemia in advanced malignant insulinoma with liver metastases.
  • This approach may be particularly beneficial when conventional therapies are ineffective or poorly tolerated.