Malignant insulinoma

Spectrum of unusual clinical features

Boaz Hirshberg, Craig Cochran, Monica C. Skarulis, Steven K. Libutti, H. Richard Alexander, Bradford J. Wood, Richard Chang, David E. Kleiner, Phillip Gorden

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

BACKGROUND. Malignant insulinoma occurs in a few patients with insulinoma. Due to the small sample of patients, there are little data regarding their clinical manifestation as well as the preferred treatment modalities. The aims of the current study were to summarize the National Institutes of Health experience during the last two decades and to conduct a critical review of the current literature. METHODS. The authors identified 10 patients with metastatic insulinoma. RESULTS. The patients presented with four patterns of clinical behavior. First, four patients presented with lymph node metastasis and, after surgical excision, maintained a prolonged tumor-free survival. Second, four patients presented with metastatic disease to the liver, which appeared years after the initial diagnosis and presumed curative surgery. Third, one patient presented with a large α-fetoprotein-secreting liver mass. Finally, 9 of the 10 patients had a prolonged survival. Various treatment modalities were used to control hypoglycemia. Short-term benefits were most often achieved with embolization and diazoxide. Less successful modalities included radiofrequency ablation, radical debulking surgery, verapamil therapy, octreotide therapy, and chemotherapy. CONCLUSIONS. The current study, as well as others, suggested that metastatic insulinoma may have a variable natural history. After the initial surgical resection, the biology of the tumor, rather than any treatment modality, was most likely the major determinant of long-term survival.

Original languageEnglish (US)
Pages (from-to)264-272
Number of pages9
JournalCancer
Volume104
Issue number2
DOIs
StatePublished - Jul 15 2005
Externally publishedYes

Fingerprint

Insulinoma
Survival
Fetal Proteins
Diazoxide
Therapeutics
Octreotide
National Institutes of Health (U.S.)
Verapamil
Natural History
Hypoglycemia
Liver Diseases
Neoplasms
Lymph Nodes
Neoplasm Metastasis
Drug Therapy
Liver

Keywords

  • Beta-cell tumor
  • Endocrine
  • Insulinoma
  • Neoplasia

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Hirshberg, B., Cochran, C., Skarulis, M. C., Libutti, S. K., Alexander, H. R., Wood, B. J., ... Gorden, P. (2005). Malignant insulinoma: Spectrum of unusual clinical features. Cancer, 104(2), 264-272. https://doi.org/10.1002/cncr.21179

Malignant insulinoma : Spectrum of unusual clinical features. / Hirshberg, Boaz; Cochran, Craig; Skarulis, Monica C.; Libutti, Steven K.; Alexander, H. Richard; Wood, Bradford J.; Chang, Richard; Kleiner, David E.; Gorden, Phillip.

In: Cancer, Vol. 104, No. 2, 15.07.2005, p. 264-272.

Research output: Contribution to journalArticle

Hirshberg, B, Cochran, C, Skarulis, MC, Libutti, SK, Alexander, HR, Wood, BJ, Chang, R, Kleiner, DE & Gorden, P 2005, 'Malignant insulinoma: Spectrum of unusual clinical features', Cancer, vol. 104, no. 2, pp. 264-272. https://doi.org/10.1002/cncr.21179
Hirshberg B, Cochran C, Skarulis MC, Libutti SK, Alexander HR, Wood BJ et al. Malignant insulinoma: Spectrum of unusual clinical features. Cancer. 2005 Jul 15;104(2):264-272. https://doi.org/10.1002/cncr.21179
Hirshberg, Boaz ; Cochran, Craig ; Skarulis, Monica C. ; Libutti, Steven K. ; Alexander, H. Richard ; Wood, Bradford J. ; Chang, Richard ; Kleiner, David E. ; Gorden, Phillip. / Malignant insulinoma : Spectrum of unusual clinical features. In: Cancer. 2005 ; Vol. 104, No. 2. pp. 264-272.
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