[Treatment of metastatic malignant insulinomas. 2 cases]

Malignant insulinomas are slow growing tumours for which the prognosis is worsened by metastatic disease and sequellae of excess hormone secretion. Management of unresectable tumours includes intravenous chemotherapy and local treatments such as palliative surgery and transcatheter arterial embolization of liver metastases. Long-term survival can also be improved by inhibition of secretory products of the tumour with either octreotide, a somatostatin analogue, or diazoxide. We report two cases of malignant insulinomas with liver metastases for which objective responses were obtained with combination of local treatment and intravenous chemotherapy.