Management of intractable hypoglycemia with Yttirum-90 radioembolization in a patient with malignant insulinoma

Prakash Chandra, Shadi Sadeghi Yarandi, Natasha Khazai, Sol Jacobs, Guillermo E. Umpierrez

Research output: Contribution to journalArticlepeer-review

Abstract

Metastatic insulinomas may present with recurrent life-threatening hypoglycemia. Treatment of hypoglycemia in such patients is difficult and frequently fails to respond to numerous therapeutic agents, requiring continuous dextrose infusion. The authors present our experience with Yttirum-90 radioembolization in a patient with metastatic malignant insulinoma who failed to respond to distal pancreatectomy, systemic chemotherapy with capecitabine and everolimus and medical treatment with somatostatin analogues, diazoxide and corticosteroids. Treatment with repeated Y-90 radioembolization resulted in rapid resolution of hypoglycemic events, allowing discontinuation of dextrose infusion and hospital discharge. However, the effect of Y-90 administration seems to be transient and without evidence of tumor shrinkage in imaging studies.

Original languageEnglish (US)
Pages (from-to)414-417
Number of pages4
JournalAmerican Journal of the Medical Sciences
Volume340
Issue number5
DOIs
StatePublished - Nov 2010
Externally publishedYes

Keywords

  • Hypoglycemia
  • Insulinoma
  • Malignant insulinoma
  • Octreotide therapy
  • Yttirum-90

ASJC Scopus subject areas

  • Medicine(all)

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