Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor: A Case Report and Review of the Literature

A 56-year-old woman presented to our clinic for recurrent hypoglycemia after undergoing resection of an incidentally discovered nonfunctional pancreatic endocrine tumor 6 years ago. She underwent a distal pancreatectomy and splenectomy, after which she developed diabetes and was placed on an insulin...

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Main Authors:	Koshy, Anoopa A., Gordon, Ilyssa O., Van Ha, Thuong G., Kaplan, Edwin L., Philipson, Louis H.
Format:	Online
Language:	English
Published:	SAGE Publications 2013
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4528785/

id	pubmed-4528785
recordtype	oai_dc
spelling	pubmed-45287852015-09-30 Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor: A Case Report and Review of the Literature Koshy, Anoopa A. Gordon, Ilyssa O. Van Ha, Thuong G. Kaplan, Edwin L. Philipson, Louis H. Article A 56-year-old woman presented to our clinic for recurrent hypoglycemia after undergoing resection of an incidentally discovered nonfunctional pancreatic endocrine tumor 6 years ago. She underwent a distal pancreatectomy and splenectomy, after which she developed diabetes and was placed on an insulin pump. Pathology showed a pancreatic endocrine neoplasm with negative islet hormone immunostains. Two years later, computed tomography scan of the abdomen showed multiple liver lesions. Biopsy of a liver lesion showed a well-differentiated neuroendocrine neoplasm, consistent with pancreatic origin. Six years later, she presented to clinic with 1.5 years of recurrent hypoglycemia. Laboratory results showed elevated proinsulin, insulin levels, and c-peptide levels during a hypoglycemic episode. Computed tomography scan of the abdomen redemonstrated multiple liver lesions. Repeated transarterial catheter chemoembolization and microwave thermal ablation controlled hypoglycemia. The unusual features of interest of this case include the transformation of nonfunctioning pancreatic endocrine tumor to a metastatic insulinoma and the occurrence of atrial flutter after octreotide for treatment. SAGE Publications 2013-01-01 /pmc/articles/PMC4528785/ /pubmed/26425568 http://dx.doi.org/10.1177/2324709612473274 Text en © 2013 American Federation for Medical Research http://creativecommons.org/licenses/by/3.0/ This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm).
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Koshy, Anoopa A. Gordon, Ilyssa O. Van Ha, Thuong G. Kaplan, Edwin L. Philipson, Louis H.
spellingShingle	Koshy, Anoopa A. Gordon, Ilyssa O. Van Ha, Thuong G. Kaplan, Edwin L. Philipson, Louis H. Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor: A Case Report and Review of the Literature
author_facet	Koshy, Anoopa A. Gordon, Ilyssa O. Van Ha, Thuong G. Kaplan, Edwin L. Philipson, Louis H.
author_sort	Koshy, Anoopa A.
title	Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor: A Case Report and Review of the Literature
title_short	Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor: A Case Report and Review of the Literature
title_full	Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor: A Case Report and Review of the Literature
title_fullStr	Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor: A Case Report and Review of the Literature
title_full_unstemmed	Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor: A Case Report and Review of the Literature
title_sort	metastatic insulinoma following resection of nonsecreting pancreatic islet cell tumor: a case report and review of the literature
description	A 56-year-old woman presented to our clinic for recurrent hypoglycemia after undergoing resection of an incidentally discovered nonfunctional pancreatic endocrine tumor 6 years ago. She underwent a distal pancreatectomy and splenectomy, after which she developed diabetes and was placed on an insulin pump. Pathology showed a pancreatic endocrine neoplasm with negative islet hormone immunostains. Two years later, computed tomography scan of the abdomen showed multiple liver lesions. Biopsy of a liver lesion showed a well-differentiated neuroendocrine neoplasm, consistent with pancreatic origin. Six years later, she presented to clinic with 1.5 years of recurrent hypoglycemia. Laboratory results showed elevated proinsulin, insulin levels, and c-peptide levels during a hypoglycemic episode. Computed tomography scan of the abdomen redemonstrated multiple liver lesions. Repeated transarterial catheter chemoembolization and microwave thermal ablation controlled hypoglycemia. The unusual features of interest of this case include the transformation of nonfunctioning pancreatic endocrine tumor to a metastatic insulinoma and the occurrence of atrial flutter after octreotide for treatment.
publisher	SAGE Publications
publishDate	2013
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4528785/
_version_	1613256948025655296

Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor: A Case Report and Review of the Literature

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