Language

English

Publication Date

1-1-2023

Journal

ACG Case Reports Journal

DOI

10.14309/crj.0000000000000954

PMID

38445216

PMCID

PMC10914231

PubMedCentral® Posted Date

1-27-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Pancreatic neuroendocrine tumors are rare neoplasms characterized into nonfunctioning (NF-PNET) and functioning (F-PNET) subtypes. F-PNETs typically involve overt symptoms related to excessive hormone secretion but may rarely present first as NF-PNETs with delayed transformation. We present a patient with known NF-PNET with liver metastases who developed hypoglycemia 2 years after initial diagnosis due to malignant insulinoma. Hypoglycemia was refractory to continuous dextrose but improved temporarily after diazoxide and hepatic artery embolization. Malignant insulinomas are usually metastatic at presentation and portend poor prognosis. Hypoglycemia may be medically managed with steroids, somatostatin analogues, and diazoxide, along with therapies to reduce tumor burden.

Keywords

pancreatic neuroendocrine tumor, insulinoma, hepatic artery embolization, diazoxide, liver metastases

Published Open-Access

yes

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