Intra-arterial liver chemotherapy and hormone therapy in malignant insulinoma: case report and review of the literature.
BACKGROUND
Malignant insulinoma is a rare tumor. Metastatic disease confined to the liver can be treated with various locoregional treatments.


METHODS
We report a case of a young woman who developed liver metastases twelve years following resection of a pancreatic insulinoma positive to anti-insulin antibodies. With five cycles of intra-arterial locoregional chemotherapy (fluorouracil and epirubicin) to the liver and monthly hormone therapy (octreotide) the patient obtained a clinical complete response. After twelve months she is still disease free.


CONCLUSIONS
Locoregional therapy for insulinoma metastatic to the liver might represent the treatment of choice; hepatic intra-arterial chemotherapy is an interesting therapeutic approach which deserves attention. The role of somatostatin analogs is limited to symptom control.
Moscetti
L
L
Department of Experimental Medicine, University La Sapienza, Policlinico Umberto I, Rome, Italy.
Saltarelli
R
R
Giuliani
R
R
Fornarini
G
G
Bezzi
M
M
Cortesi
E
E
D000328:Adult; D000912:Antibodies, Neoplasm / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007261:Infusions, Intra-Arterial; D007328:Insulin / Q000276:immunology; D007340:Insulinoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000276:immunology / Q000556:secondary*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000276:immunology / Q000556:secondary*; D015282:Octreotide / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000276:immunology / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000912:Antibodies, Neoplasm; D007328:Insulin; D015251:Epirubicin; D015282:Octreotide; D005472:Fluorouracil