title: Rapidly progressing malignant insulinoma presented with multiple liver metastases: a case report.
abstract: BACKGROUND
  A 51-year-old female was admitted to emergency unit with sudden loss of consciousness. Her blood glucose level from fingertip was 33 mg/dl, and insulin level was 55 (normal range, 4-17 IU). Abdominal ultrasonography revealed pancreatic mass with diffuse liver metastases. Biopsy of liver metastases showed differentiated neuroendocrine carcinoma.
  
  
  RESULTS
  Diazoxide and chemotherapy stabilized her glucose level for more than 4 months. However, the disease showed progression, and death occurred 8 months later.
  
  
  CONCLUSIONS
  In conclusion, this case may suggest that biologic behavior may differ from histological behavior in insulinoma and platin-based systemic chemotherapy may provide some benefit in patients those who had diazoxide- and octreotide-resistant tumors.
authors.affiliation: Departments of Gastroenterology, Baskent University, Ankara, Turkey.
authors.forename: Askin
authors.initials: A
authors.lastname: Erdogan
authors.forename: Erdogan
authors.initials: E
authors.lastname: Askin
authors.forename: Fatih
authors.initials: F
authors.lastname: Kose
authors.forename: Kose
authors.initials: K
authors.lastname: Fatih
authors.forename: Hampar
authors.initials: H
authors.lastname: Akkaya
authors.forename: Akkaya
authors.initials: A
authors.lastname: Hampar
authors.forename: Neslihan
authors.initials: N
authors.lastname: Bascil Tutuncu
authors.forename: Neslihan Bascil
authors.initials: NB
authors.lastname: Tutuncu
authors.forename: Ozgur
authors.initials: O
authors.lastname: Ozyilkan
authors.forename: Ozyilkan
authors.initials: O
authors.lastname: Ozgur
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D003981:Diazoxide / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000188:drug therapy / Q000556:secondary*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary*; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology*; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D014665:Vasodilator Agents; D003981:Diazoxide; D015282:Octreotide