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Insulinoma after streptozotocin therapy for metastatic gastrinoma: natural history or iatrogenic complication?

Abstract
Islet cell carcinoma frequently produces more than one chemical product, although its clinical expression is usually restricted to a single hormone. We describe an unusual patient who presented with full-blown metastasizing gastrinoma. He was treated with cimetidine for five years and then streptozotocin therapy, which resulted in a regression in hepatomegaly and a fall in serum gastrin levels. Following one year's therapy with streptozotocin, he was admitted in hyperinsulinemic hypoglycemic stupor. This appears to be the first reported case of a "shift" from clinical gastrinoma to insulinoma possibly related to prolonged streptozotocin therapy.
AuthorsM Bar, M Burke, A Isakov, C Almog
JournalJournal of clinical gastroenterology (J Clin Gastroenterol) Vol. 12 Issue 5 Pg. 579-80 (Oct 1990) ISSN: 0192-0790 [Print] United States
PMID2172360 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Streptozocin
Topics
  • Adenoma, Islet Cell (chemically induced, secondary)
  • Aged
  • Gastrinoma (drug therapy, secondary)
  • Humans
  • Insulinoma (chemically induced)
  • Liver Neoplasms (drug therapy, secondary)
  • Lymphatic Metastasis
  • Male
  • Pancreatic Neoplasms (chemically induced, secondary)
  • Stomach Neoplasms (drug therapy, secondary)
  • Streptozocin (adverse effects, therapeutic use)

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