title: Liver metastases 9 years after removal of a malignant insulinoma which was initially considered benign.
abstract: BACKGROUND
  Insulinomas may be regarded as potentially malignant. A long follow-up period is needed to detect any possible recurrence, even if the initial diagnosis was of a benign insulinoma.
  
  
  METHODS
  We present the case of a 76-year-old woman with liver metastases due to a malignant insulinoma, which had been diagnosed as benign after its complete removal 9 years earlier.
  
  
  CONCLUSIONS
  This case shows the difficulty of distinguishing between benign and malignant insulinomas when there is no initial evidence of metastases. This fact poses the need to conduct a long follow-up period in order to detect any possible recurrence even if the initial diagnosis was one of a benign insulinoma.
authors.affiliation: Department of Endocrinology and Nutrition, University Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain. abelypaloma@tiscali.es
authors.forename: Abel
authors.initials: A
authors.lastname: Gonzalez-Gonzalez
authors.forename: Jose María
authors.initials: JM
authors.lastname: Recio-Cordova
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000601:surgery*; D008113:Liver Neoplasms / Q000556:secondary*; D010182:Pancreatic Diseases / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D013997:Time Factors