Everolimus Controlled Resistant Hypoglycemia in Malignant Insulinoma

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Introduction: A pancreatic neuroendocrine carcinoma with liver metastases was diagnosed on July 2006 in a 65-year-old man. He was treated with octreotide LAR 30 mg for three years. At liver progression he was enrolled in a multicenter Italian trial titled “XELBEVOCT” with Bevacizumab + Metronomic Capecitabine + Octreotide LAR 30 mg. After seven months, the patient exhibited severe hypoglycemic syndrome with HGT serum levels<30 mg/dl, insulin 150 microUI/ml, and C-peptide at upper normal limits. Endocrinologist prescribed prednisone, diazoxide and recombinant glucagon for hypoglicemic crisis, with little benefit. In March 2010, the patient was given radio-labelled Lu-177-OCTREOTATE treatment. After three cycles, hypoglicemic symptoms were still uncontrolled. CT scan showed stable disease.

Aim(s): Considering persistent hypoglycemic syndrome, Everolimus was introduced.

Materials and methods: Everolimus 10 mg daily was administered in combination with radiometabolic treatment.

Conference: 9th Annual ENETSConcerence (2012)

Presenting Author:

Authors: Ferrero A, Bellini E, Brizzi M, Pia A, Ottone A,

Keywords: malignant insulinoma, everolimus, resistant hypoglycemia,

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