Malignant Insulinoma in a Patient with Diabetes: Response to Treatment and a Return to Insulin Injections

#1101

Introduction: A 64 year old male with a fourteen year history of diabetes had been treated with insulin for eight years. Over a four week period he noticed that his insulin requirements were reducing and he experienced episodes of symptomatic hypoglycaemia and upper abdominal pain. Following referral a CT scan was performed which revealed numerous liver metastases and a 8.4 by 5.2 cm mass replacing the pancreas. Liver biopsy diagnosed a neuroendocrine tumour with a MIB-1 index of up to 18%. The tumour was somatostatin receptor positive as evidenced by an octreotide scan.

Aim(s): An effective treatment was required as Everolimus and chemotherapy were not successful.

Materials and methods: Following discontinuation of Everolimus due to toxicity and unsuccessful treatment with chemotherapy (Streptozocin and Capecitabine) the patient was treated with PRRT (Peptide Receptor Radionuclide Therapy). He received 7,400 MBq Lu177 DOTATATE as a single treatment.

Conference: 12th Annual ENETSConcerence (2015)

Presenting Author: Sherriff D

Authors: Sherriff D, Drake B,

Keywords: insulinoma, diabetes, prrt,