Malignant insulinoma: Report of 6 patients and literature review.
OBJECTIVE
Patients with malignant insulinoma always present with symptoms of severe hypoglycemia and have poor life expectancy. In addition, inoperable metastatic malignant insulinomas are very difficult to manage. The aim of this report is to present our successful experiences in diagnosis and treatment of this disease in 6 patients.


METHODS
Six patients (male 2, female 4) with malignant insulinomas were admitted into our hospital. Their clinical histories, including clinical presentations, endocrine evaluations, radiological images, pathological examination and treatments, were reviewed.


RESULTS
The diagnosis of malignant insulinoma combined with liver metastases was confirmed in all patients by endocrine evaluation and radiological images. Patients 1-3 underwent surgical management. The primary and metastasized tumors were completely resected. After successful surgery, no hypoglycemia recurred. Patients 4-6 did not undergo surgery because of systemic disease and poor health. Instead, they were administrated with diazoxide 50 mg Three Times a Day (TID), with final doses up to 200-300 mg TID. These 3 patients had good responses to diazoxide administration. After treatment, the frequency and severity of hypoglycemia were improved significantly. All 6 patients had better life quality than previously expected.


CONCLUSIONS
Combination of surgical and medical approaches can improve life quality and prolong survival of patients with malignant insulinomas.
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China, China.
Yi
Y
Shao
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China, China.
Yu-Qing
YQ
Qu
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China, China.
Xian-Ling
XL
Wang
Department of Pathology, Chinese PLA General Hospital, Beijing, China.
Zhi-Gang
ZG
Song
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China, China.
Qing-Hua
QH
Guo
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China, China.
Jing-Tao
JT
Dou
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China, China.
Jian-Ming
JM
Ba
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China, China.
Zhao-Hui
ZH
Lü
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China, China.
Yi-Ming
YM
Mu
D000328:Adult; D003981:Diazoxide / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy / Q000209:etiology; D007340:Insulinoma / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D012189:Retrospective Studies; D055815:Young Adult
D004232:Diuretics; D003981:Diazoxide