Immediate and sustained response of hypoglycaemia to Streptozotocin-based chemotherapy in metastatic Insulinoma: A case report

#4022

Introduction: Hypoglycaemia due to insulin production from insulinomas can be challenging to manage. The evidence base for systemic treatment selection is small.

Aim(s): We describe the use of Streptozotocin-based cytotoxic chemotherapy as treatment for refractory hypoglycaemia.

Materials and methods: A 64 year-old man was diagnosed with unresectable metastatic malignant insulinoma (well differentiated, Ki-67 index 27%) in 2021. He was treated with Everolimus and then with radioligand therapy (Lu177 dotatate). In 2022, he developed progressive liver metastases unresponsive to somatostatin analogues and trans-arterial embolization. He experienced significantly worsening hypoglycaemic episodes eventually leading to hospital admission. Treatment with frequent oral carbohydrate, intravenous dextrose, diazoxide and corticosteroids was unsuccessful. Chemotherapy was given as a combination of Streptozotocin, Carboplatin and Fluorouracil.

Conference:

Presenting Author:

Authors: Sherriff D, Flanagan D,

Keywords: insulinoma, hypoglycaemia, streptozotocin,