Metastatic insulinoma with long survival and glucagonoma syndrome.

Abstract

In 1966, during cholecystectomy for cholecystolithiasis, a 56-year-old man was found to have islet-cell carcinoma metastatic to the liver; his fasting serum glucose level was normal. In 1971, he developed peptic ulcer disease and symptoms of fasting hypoglycemia; inappropriate secretion of insulin was shown. His primary pancreatic tumor was removed in 1973. During the next 9 years, his liver metastases continued to grow and his fasting serum glucose level was maintained at 35 to 116 mg/dL with diazoxide and hydrochlorothiazide therapy. In 1982, he developed clinical evidence of the glucagonoma syndrome, with glucagon levels between 4000 and 11 000 pg/mL. Since then, his fasting serum glucose level has been maintained at 58 to 119 mg/dL without medication. This patient has survived 17 years with a malignant insulinoma and without islet-cell chemotherapy. His course shows that malignant insulinomas may secrete other peptide hormones that can induce various clinical syndromes.

• Authors: C M D'Arcangues, S Awoke, G D Lawrence
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 100 Issue 2 Pg. 233-5 (Feb 1984) ISSN: 0003-4819 [Print] United States
• PMID: 6318634 (Publication Type: Case Reports, Journal Article)

Chemical References

• Blood Glucose

Topics

• Adenoma, Islet Cell (physiopathology, secondary)
• Blood Glucose (metabolism)
• Glucagonoma (blood, physiopathology)
• Humans
• Insulinoma (blood, physiopathology, secondary)
• Liver Neoplasms (physiopathology, secondary)
• Male
• Middle Aged
• Pancreatic Neoplasms (blood, physiopathology)