title: Malignant insulinoma which expressed a unique creatine kinase isoenzyme: clinical value of arterial embolization as a palliative therapy.
abstract: A 76-year-old man with hypoglycemic coma was diagnosed as malignant insulinoma with multiple hepatic metastases. Embolization was done for two-thirds of the hepatic mass and it rapidly lowered the serum immunoreactive insulin. He was discharged without medication and has been free from hypoglycemia. After the embolization, the serum creatine kinase (CK) level increased transiently although there was no evidence of myocardial infarction. On electrophoresis, the CK activity showed an abnormal peak, suggesting mitochondrial CK. CK release after embolization has been reported in only a few cases with endocrine tumors, which might indicate some relationship between active energy metabolism and mitochondrial CK.
authors.affiliation: Fourth Department of Internal Medicine, School of Medicine, University of Tokyo.
authors.forename: M
authors.initials: M
authors.lastname: Hayashi
authors.forename: K
authors.initials: K
authors.lastname: Takaichi
authors.forename: T
authors.initials: T
authors.lastname: Kariya
authors.forename: H
authors.initials: H
authors.lastname: Kanbe
authors.forename: N
authors.initials: N
authors.lastname: Hayashi
authors.forename: M
authors.initials: M
authors.lastname: Honsei
authors.forename: S
authors.initials: S
authors.lastname: Hayashi
authors.forename: H
authors.initials: H
authors.lastname: Yasuda
authors.forename: T
authors.initials: T
authors.lastname: Ueno
authors.forename: T
authors.initials: T
authors.lastname: Fujita
mesh_terms: D000368:Aged; D016461:Chemoembolization, Therapeutic; D003402:Creatine Kinase / Q000096:biosynthesis*; D006801:Humans; D007340:Insulinoma / Q000201:enzymology* / Q000628:therapy*; D007527:Isoenzymes; D008297:Male; D008928:Mitochondria / Q000201:enzymology*; D010190:Pancreatic Neoplasms / Q000201:enzymology* / Q000628:therapy*
chemical_list: D007527:Isoenzymes; D003402:Creatine Kinase