We are reporting a case of 68-year-old woman with
insulinoma, after a non-successful
tumor surgery and a long-term
diazoxide treatment. She had a lot of
hypoglycemia cases, and a
weight gain of 50 kg. An abdominal CT scan demonstrated a
tumor 28 mm in the diameter, in the head of the pancreas. The patient did not agree for the repeated
insulinoma surgery. Furthermore, we found a lesion in the left adrenal gland (14 mm in the diameter) and in the right lung (8 mm in the diameter).
Pheochromocytoma was diagnosed on the basis of
hypertension, elevated levels of
normetanephrine in the 24-h urine collection, and an elevated level of
norepinephrine in a plasma sample. After the left adrenal gland removal we observed lower blood pressure. Since we had revealed the presence of
somatostatin receptors by the
somatostatin receptors scintigraphy, we decided to control
hypoglycemia by a monthly subcutaneous administration of the long-acting
lanreotide. Because of higher
glucose levels (300-400 mg/dl) we started an intense
insulin therapy. Nowadays, the patient feels better, she has lost 20 kg of her
body weight, and we have observed normal
blood glucose levels during the long-term
lanreotide treatment. We have noticed neither side effects nor
hypoglycemic episodes and we have reduced the dose of
insulin. The presented case can be an evidence of the effective treatment of the pancreatic
neuroendocrine tumor of
insulinoma type, with
somatostatin analogue.