title: [Malignant insulinoma: recommendations for workup and treatment].
abstract: Insulinoma are malignant in 4 to 14 % of cases. Their rarity and the sparse data available in the literature have limited publication of specific guidelines for their management. The following review aim to provide up-to-date recommendations on initial evaluation including pathologic grading, measures to control hypoglycemia, antitumor strategies and long term follow-up. Will be discussed in detail respective indications of surgery, diazoxide, somatostatin analogs, everolimus, sunitinib, liver directed treatments including arterial embolization, chemotherapy and radiometabolic therapy. A Medline search using terms "insulinoma", "neuroendocrine pancreatic tumors", "islet cell carcinoma", "malignant insulinoma" was performed limiting the selection to English language articles and adult age cases, along with cross referencing.
authors.affiliation: Institut Gustave-Roussy, service de médecine nucléaire et d'oncologie endocrinienne, 94805 Villejuif cedex, France. Electronic address: eric.baudin@igr.fr.
authors.forename: Eric
authors.initials: E
authors.lastname: Baudin
authors.affiliation: CHU Rangueil-Larrey, pôle cardiovasculaire et métabolique, service d'endocrinologie et maladies métaboliques, 31059 Toulouse cedex 9, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Caron
authors.affiliation: Hôpital Édouard-Herriot, Fédération des spécialités digestives, 69003 Lyon, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lombard-Bohas
authors.affiliation: Hôpital Haut-Lévêque, service d'endocrinologie, 33600 Pessac, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Tabarin
authors.affiliation: Institut Curie, hôpital René-Huguenin, service d'onco-gastroentérologie, 92210 Saint-Cloud, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mitry
authors.affiliation: CHU Côte-de-Nacre, unité fonctionnelle d'endocrinologie et maladies métaboliques, 14033 Caen cedex, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Reznick
authors.affiliation: CHU de la Timone, service central de biophysique et de médecine nucléaire, 13005 Marseille, France.
authors.forename: David
authors.initials: D
authors.lastname: Taieb
authors.affiliation: Hôpital Claude-Huriez, service de chirurgie endocrinienne, 59000 Lille, France.
authors.forename: François
authors.initials: F
authors.lastname: Pattou
authors.affiliation: CHU de Dijon, service de chirurgie générale et endocrinienne, 21000 Dijon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Goudet
authors.affiliation: CHU Rangueil-Larrey, pôle cardiovasculaire et métabolique, service d'endocrinologie et maladies métaboliques, 31059 Toulouse cedex 9, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Vezzosi
authors.affiliation: Institut Gustave-Roussy, service de biologie et de pathologie médicales, 94805 Villejuif cedex, France.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Scoazec
authors.affiliation: Hôpital Robert-Debré, service d'hépato-gastro-entérologie et de cancérologie digestive, 51100 Reims, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cadiot
authors.affiliation: Hospices Civils de Lyon, Fédération d'endocrinologie du pole Est, Fédération d'endocrinologie et centre de médecine nucléaire, 69500 Lyon, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Borson-Chazot
authors.affiliation: Hôpital Claude-Huriez, service d'endocrinologie et de maladies métaboliques, 59000 Lille, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Do Cao
mesh_terms: D003131:Combined Modality Therapy; D007003:Hypoglycemia / Q000175:diagnosis / Q000628:therapy; D007340:Insulinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D008207:Lymphatic Metastasis / Q000473:pathology; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D047368:Tumor Burden