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Case Reports
. 2011 Aug;17(8):CS103-107.
doi: 10.12659/msm.881891.

Metastatic insulinoma - prolonged survival after multimodal approach

Alexander F Hagel  1 , Wolfgang H Hagel, Annette S Lindner, Ferdinand J Kammerer, Markus F Neurath, Peter C Konturek, Igor A Harsch
Affiliations
Case Reports

Metastatic insulinoma - prolonged survival after multimodal approach

Alexander F Hagel et al. Med Sci Monit. 2011 Aug.

Abstract

Background: Metastatic insulinoma is a disease associated with a poor life expectancy.

Case report: The case of a presently 68 year old female with malignant, metastatic insulinoma is reported. Due to severe clinical symptoms surgical tumor mass reduction was conducted. Furthermore the patient underwent a chemotherapy using streptozotocine and fluorouracil. After two years without any symptoms, the remaining hepatic metastases increased in size and again hypoglycemias occurred. To reachieve an asymptomatic state and further reduction in tumor mass, the decision was made for transarterial chemoembolization with streptozotocine. After the first treatment the patient was hypoglycemia - free for 3 months, after another more extensive chemoembolization the patient is presently symptom free for 8 months.

Conclusions: Since the diagnosis of extended disease was established, the patient has survived for 36 months. We regard this as the result of a multimodal approach and the extensive use of local tumor therapy. The different therapeutic options for local tumor therapy are reported and discussed.

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Figures

Figure 1
Figure 1
Abdominal MRI: Pancreatic tumor, invading the spleen, hepatic metastases.
Figure 2
Figure 2
Angiography before (A) and after (B) TACE: Liver metastasis in segment VI.
Figure 3
Figure 3
Liver Metastasis in segment VII before (A) and after (B) TACE.
See this image and copyright information in PMC

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