Malignant Insulinoma Arising From Nonfunctioning Pancreatic Neuroendocrine Tumor. Issue 1 (27th January 2023)

• Record Type: Journal Article
• Authors: Chatterjee, Ritodhi; Ali, Basim; Nguyen, Son H.; Chen, Rui; Sada, Yvonne H.
• Is Part Of: ACG Case Reports Journal. Volume 10:Issue 1(2023)
• Page Start: e00954
• Publication Date: 2023-01-27
• Subjects: pancreatic neuroendocrine tumor -- insulinoma -- hepatic artery embolization -- diazoxide -- liver metastases
• DOI: 10.14309/crj.0000000000000954
• Languages: English
• ISSNs: 2326-3253

Abstract

ABSTRACT: Pancreatic neuroendocrine tumors are rare neoplasms characterized into nonfunctioning (NF-PNET) and functioning (F-PNET) subtypes. F-PNETs typically involve overt symptoms related to excessive hormone secretion but may rarely present first as NF-PNETs with delayed transformation. We present a patient with known NF-PNET with liver metastases who developed hypoglycemia 2 years after initial diagnosis due to malignant insulinoma. Hypoglycemia was refractory to continuous dextrose but improved temporarily after diazoxide and hepatic artery embolization. Malignant insulinomas are usually metastatic at presentation and portend poor prognosis. Hypoglycemia may be medically managed with steroids, somatostatin analogues, and diazoxide, along with therapies to reduce tumor burden.