J Korean Soc Endocrinol.  1994 Jun;9(2):150-155.

A Case of Malignant Insulinoma Treated with Streptozotocin after Surgery

• Jun YC
• Lim BH
• Son BJ
• Kim BI
• Lee MH
• Lee SJ
• Pae WK
• Kim MS

Abstract

Insulinoma is clinically characterized by fasting hypoglycemia, various neuropsychiatric symptoms, and these caused by secondary to hypoglycemia.Of patients with insulinoma, 80 percent have single benign tumors, 11 percent have multiple benign tumors, 6 percent have single malignant tumors, and the remainder have multiple malignant tumors or islet hyperplasia according to Service's statement.A 42 year-old male chemical engineer who had insulinoma associated with regional lymph node metastasis has been successfully performed with curative resection and consecutive postoperative therapy with streptozotocin.He entered to this hospital because of frequent occasion of bizarre behavior and language, transient unconsiousness and syncopal episode, and sweating associated with hypoglycemia especially in night four months prior to addmission in November 1992. Those symptoms and hypoglycemia were controlled by intravenous glucose injection and/or oral feeding of glucose riched stuffs.No physical abnormalities were found except neuropsychiatric symptoms. On admission the fasting blood glucose level was 10 mg/dl, plasma immunoreactive plasma insulin level was 125.23 uU/ml, and plasma C-peptide level was 10.24 ng/ml, respectively.Abdominal CT was suggestive of retroperitoneal tumor just behind the pancreas. Selective celiac axis angiography demonstrated hypervascular mass supplied by dorsal pancreatic artery which was compatible with insulinoma. Surgical intervention including distal pancreatectomy, as well as splenectomy and parital omental resection were performed successfully. Consecutive postoperative treatment of streptozotocin was done without any side effects.His condition is very good and enjoyed his life with full activity to date.

MeSH Terms

Angiography
Arteries
Blood Glucose
C-Peptide
Fasting
Glucose
Humans
Hyperplasia
Hypoglycemia
Insulin
Insulinoma*
Lymph Nodes
Male
Neoplasm Metastasis
Pancreas
Pancreatectomy
Plasma
Splenectomy
Streptozocin*
Sweat
Sweating
Syncope
Blood Glucose
C-Peptide
Glucose
Insulin
Streptozocin