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

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

Research output: Contribution to journalArticle

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 - Jan 1 2010
Externally publishedYes

Fingerprint

Insulinoma
Hypoglycemia
Diazoxide
Glucose
Pancreatectomy
Therapeutics
Somatostatin
Hypoglycemic Agents
Adrenal Cortex Hormones
Drug Therapy
Neoplasms

Keywords

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

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Management of intractable hypoglycemia with Yttirum-90 radioembolization in a patient with malignant insulinoma. / Chandra, Prakash; Yarandi, Shadi; Khazai, Natasha; Jacobs, Sol; Umpierrez, Guillermo E.

In: American Journal of the Medical Sciences, Vol. 340, No. 5, 01.01.2010, p. 414-417.

Research output: Contribution to journalArticle

Chandra, Prakash ; Yarandi, Shadi ; Khazai, Natasha ; Jacobs, Sol ; Umpierrez, Guillermo E. / Management of intractable hypoglycemia with Yttirum-90 radioembolization in a patient with malignant insulinoma. In: American Journal of the Medical Sciences. 2010 ; Vol. 340, No. 5. pp. 414-417.
@article{59dbce4e9f86476ca47eebb0e7b0e111,
title = "Management of intractable hypoglycemia with Yttirum-90 radioembolization in a patient with malignant insulinoma",
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.",
keywords = "Hypoglycemia, Insulinoma, Malignant insulinoma, Octreotide therapy, Yttirum-90",
author = "Prakash Chandra and Shadi Yarandi and Natasha Khazai and Sol Jacobs and Umpierrez, {Guillermo E.}",
year = "2010",
month = "1",
day = "1",
doi = "10.1097/MAJ.0b013e3181ee7be2",
language = "English (US)",
volume = "340",
pages = "414--417",
journal = "American Journal of the Medical Sciences",
issn = "0002-9629",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Management of intractable hypoglycemia with Yttirum-90 radioembolization in a patient with malignant insulinoma

AU - Chandra, Prakash

AU - Yarandi, Shadi

AU - Khazai, Natasha

AU - Jacobs, Sol

AU - Umpierrez, Guillermo E.

PY - 2010/1/1

Y1 - 2010/1/1

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

UR - http://www.scopus.com/inward/record.url?scp=78349309297&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78349309297&partnerID=8YFLogxK

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 -