Post-partum insulinoma in a MEN1 patient submitted to pancreatic electroporation

#3844

Introduction: Pancreatic neuroendocrine tumors (panNET) are a frequent manifestation of MEN1 syndrome. Insulinomas are often surgically treated.

Aim(s): To describe an alternative, minimally invasive treatment for benign insulinoma.

Materials and methods: 29-year-old female patient, history of rhinitis and asthma, admitted after a MEN1 mutation was detected (c.124G>T, p.Gly42Cys). Clinical, analytical and radiological evaluation revealed normocalcemic hyperparathyroidism, with negative imaging, as well as a clinically non-functioning 8 mm panNET kept under surveillance. Pituitary function and MRI were normal, no other features. After 6y f-up, the patient became pregnant after IVF treatment, with pre-implantation genetic diagnosis. Pregnancy and partum without complications. Three months later, presented with severe hypoglycaemia and endogenous hyperinsulinism. Abdominal CT showed 3 new panNET. 68-Ga-DOTANOC-PET/CT showed uptake in 3 nodules; no uptake in the biggest (22x15mm). 18F-FDG-PET was negative. Severe hypoglycaemia persisted, even on medical therapy, she couldn`t take care of her baby; electroporation was decided.

Conference:

Presenting Author: Gil-Santos S

Authors: Gil-Santos S, Santos A, Carvalho A, Oliveira J, Souteiro P,

Keywords: insulinoma, electroporation, pancreatic neuroendocrine tumor, MEN1,