Embolization as an alternative treatment of insulinoma in a patient with multiple endocrine neoplasia type 1 syndrome.
Insulinoma is a rare neuroendocrine tumor, most commonly originating from the pancreas, which is either sporadic or familial as a component of multiple endocrine neoplasia type 1 syndrome (MEN1). It is characterized by increased insulin secretion leading to hypoglycemia. Surgical removal is considered the treatment of choice, with limited side effects and relatively low morbidity and mortality, both being improved by the laparoscopic procedure. We present the case of a 30-year-old patient with MEN1 and recurrent insulinoma with severe hypoglycemic episodes who could not be surgically treated due to the adherence of the tumor to large blood vessels and to prior multiple surgical operations. He was treated by repeated embolization using spherical polyvinyl alcohol particles, resulting in shrinkage of the tumor, improvement of the frequency and severity of the hypoglycemic episodes, and better quality of life.
Peppa
Melpomeni
M
Endocrine Unit, Second Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, Athens University Medical School, Attikon University Hospital, Athens, Greece. molypepa@otenet.gr
Brountzos
Epsilonlias
E
Economopoulos
Nicolaos
N
Boutati
Eleni
E
Pikounis
Vasilios
V
Patapis
Paul
P
Economopoulos
Theofanis
T
Raptis
Sotirios A
SA
Hadjidakis
Dimitrios
D
D000328:Adult; D015901:Angiography, Digital Subtraction; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007340:Insulinoma / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D018761:Multiple Endocrine Neoplasia Type 1 / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D011788:Quality of Life