title: Transformation of nonfunctioning pancreatic tumor into malignant insulinoma after 3 years: an uncommon clinical course of insulinoma.
abstract: A 62-year-old man admitted to our outpatient clinic with two months of recurrent life threatening hypoglycemia episodes. He was diagnosed as malignant insulinoma with multiple metastases of liver and peripancreatic lymph nodes. Liver biopsy specimen was demonstrated grade 2 neuroendocrine tumor compatible with clinical and radiological results. He was followed under the treatment of continuous intravenous glucose infusion during the diagnostic procedures. He had a pancreatic lesion history measured 20 x 12 mm in diameter via the abdominal tomography examination approximately two years before the diagnosis. Unusual course of this case suggests the transformation of nonfunctioning pancreatic neuroendocrine tumor into functional insulin secreting tumor with metastases. The patient was found inoperable and started on chemotherapy.
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Muyesser Sayki
authors.initials: MS
authors.lastname: Arslan
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozbek
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Melia
authors.initials: M
authors.lastname: Karakose
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Tutal
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Bekir
authors.initials: B
authors.lastname: Ucan
authors.affiliation: Department of Pathology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Demet
authors.initials: D
authors.lastname: Yilmazer
authors.affiliation: Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Dilli
authors.affiliation: Department of Nuclear Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Salih Sinan
authors.initials: SS
authors.lastname: Gultekin
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Erman
authors.initials: E
authors.lastname: Cakal
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Delibasi
mesh_terms: D001706:Biopsy; D006801:Humans; D007003:Hypoglycemia / Q000473:pathology; D007340:Insulinoma / Q000473:pathology* / Q000556:secondary; D008113:Liver Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed