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Hepatic arterial infusion combined with systemic chemotherapy induced complete response of metachronous liver metastases after resection of pancreatic insulinoma.

Abstract
Insulinomas are the most common functioning pancreatic neuroendocrine tumors (PNETs). We herein present the case of a 5-year survivor with insulinoma after complete response of postoperative liver metastases to hepatic arterial infusion combined with systemic chemotherapy. A 58-year-old woman was admitted to our hospital following loss of consciousness. Examination revealed a pancreatic tumor, and she underwent distal pancreatectomy following diagnosis of insulinoma. Superparamagnetic iron oxide magnetic resonance imaging (SPIO-MRI) revealed multiple liver metastases 3 months after surgery. Therefore, we performed hepatic arterial infusion of 5-fluorouracil (5-FU) combined with systemic gemcitabine infusion. We observed complete ablation of all metastatic liver nodules after 11 cycles of the chemotherapy using MRI. We continued this chemotherapy regimen for 20 cycles, and the patient remains alive without any recurrence 7 years after surgery.
AuthorsYuki Kiyozumi, Hiroshi Takamori, Osamu Nakahara, Yoshiaki Ikuta, Akira Chikamoto, Toru Beppu, Hideo Baba
JournalClinical journal of gastroenterology (Clin J Gastroenterol) Vol. 6 Issue 6 Pg. 496-9 (Dec 2013) ISSN: 1865-7265 [Electronic] Japan
PMID26182143 (Publication Type: Journal Article)

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