TY - JOUR
T1 - Management of intractable hypoglycemia with Yttirum-90 radioembolization in a patient with malignant insulinoma
AU - Chandra, Prakash
AU - Yarandi, Shadi Sadeghi
AU - Khazai, Natasha
AU - Jacobs, Sol
AU - Umpierrez, Guillermo E.
PY - 2010/11
Y1 - 2010/11
N2 - 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.
AB - 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.
KW - Hypoglycemia
KW - Insulinoma
KW - Malignant insulinoma
KW - Octreotide therapy
KW - Yttirum-90
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U2 - 10.1097/MAJ.0b013e3181ee7be2
DO - 10.1097/MAJ.0b013e3181ee7be2
M3 - Article
C2 - 20724903
AN - SCOPUS:78349309297
VL - 340
SP - 414
EP - 417
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
SN - 0002-9629
IS - 5
ER -