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A case of malignant insulinoma responsive to somatostatin analogs treatment
BACKGROUND: Insulinoma is a rare tumour representing 1–2% of all pancreatic neoplasms and it is malignant in only 10% of cases. Locoregional invasion or metastases define malignancy, whereas the dimension (> 2 cm), CK19 status, the tumor staging and grading (Ki67 > 2%), and the age of onset (&...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307122/ https://www.ncbi.nlm.nih.gov/pubmed/30591061 http://dx.doi.org/10.1186/s12902-018-0325-4 |
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author | Caliri, Mariasmeralda Verdiani, Valentina Mannucci, Edoardo Briganti, Vittorio Landoni, Luca Esposito, Alessandro Burato, Giulia Rotella, Carlo Maria Mannelli, Massimo Peri, Alessandro |
author_facet | Caliri, Mariasmeralda Verdiani, Valentina Mannucci, Edoardo Briganti, Vittorio Landoni, Luca Esposito, Alessandro Burato, Giulia Rotella, Carlo Maria Mannelli, Massimo Peri, Alessandro |
author_sort | Caliri, Mariasmeralda |
collection | PubMed |
description | BACKGROUND: Insulinoma is a rare tumour representing 1–2% of all pancreatic neoplasms and it is malignant in only 10% of cases. Locoregional invasion or metastases define malignancy, whereas the dimension (> 2 cm), CK19 status, the tumor staging and grading (Ki67 > 2%), and the age of onset (> 50 years) can be considered elements of suspect. CASE PRESENTATION: We describe the case of a 68-year-old man presenting symptoms compatible with hypoglycemia. The symptoms regressed with food intake. These episodes initially occurred during physical activity, later also during fasting. The fasting test was performed and the laboratory results showed endogenous hyperinsulinemia compatible with insulinoma. The patient appeared responsive to somatostatin analogs and so he was treated with short acting octreotide, obtaining a good control of glycemia. Imaging investigations showed the presence of a lesion of the uncinate pancreatic process of about 4 cm with a high sst2 receptor density. The patient underwent exploratory laparotomy and duodenocephalopancreasectomy after one month. The definitive histological examination revealed an insulinoma (T3N1MO, AGCC VII G1) with a low replicative index (Ki67: 2%). CONCLUSIONS: This report describes a case of malignant insulinoma responsive to octreotide analogs administered pre-operatively in order to try to prevent hypoglycemia. The response to octreotide analogs is not predictable and should be initially assessed under strict clinical surveillance. |
format | Online Article Text |
id | pubmed-6307122 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63071222019-01-02 A case of malignant insulinoma responsive to somatostatin analogs treatment Caliri, Mariasmeralda Verdiani, Valentina Mannucci, Edoardo Briganti, Vittorio Landoni, Luca Esposito, Alessandro Burato, Giulia Rotella, Carlo Maria Mannelli, Massimo Peri, Alessandro BMC Endocr Disord Case Report BACKGROUND: Insulinoma is a rare tumour representing 1–2% of all pancreatic neoplasms and it is malignant in only 10% of cases. Locoregional invasion or metastases define malignancy, whereas the dimension (> 2 cm), CK19 status, the tumor staging and grading (Ki67 > 2%), and the age of onset (> 50 years) can be considered elements of suspect. CASE PRESENTATION: We describe the case of a 68-year-old man presenting symptoms compatible with hypoglycemia. The symptoms regressed with food intake. These episodes initially occurred during physical activity, later also during fasting. The fasting test was performed and the laboratory results showed endogenous hyperinsulinemia compatible with insulinoma. The patient appeared responsive to somatostatin analogs and so he was treated with short acting octreotide, obtaining a good control of glycemia. Imaging investigations showed the presence of a lesion of the uncinate pancreatic process of about 4 cm with a high sst2 receptor density. The patient underwent exploratory laparotomy and duodenocephalopancreasectomy after one month. The definitive histological examination revealed an insulinoma (T3N1MO, AGCC VII G1) with a low replicative index (Ki67: 2%). CONCLUSIONS: This report describes a case of malignant insulinoma responsive to octreotide analogs administered pre-operatively in order to try to prevent hypoglycemia. The response to octreotide analogs is not predictable and should be initially assessed under strict clinical surveillance. BioMed Central 2018-12-27 /pmc/articles/PMC6307122/ /pubmed/30591061 http://dx.doi.org/10.1186/s12902-018-0325-4 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Caliri, Mariasmeralda Verdiani, Valentina Mannucci, Edoardo Briganti, Vittorio Landoni, Luca Esposito, Alessandro Burato, Giulia Rotella, Carlo Maria Mannelli, Massimo Peri, Alessandro A case of malignant insulinoma responsive to somatostatin analogs treatment |
title | A case of malignant insulinoma responsive to somatostatin analogs treatment |
title_full | A case of malignant insulinoma responsive to somatostatin analogs treatment |
title_fullStr | A case of malignant insulinoma responsive to somatostatin analogs treatment |
title_full_unstemmed | A case of malignant insulinoma responsive to somatostatin analogs treatment |
title_short | A case of malignant insulinoma responsive to somatostatin analogs treatment |
title_sort | case of malignant insulinoma responsive to somatostatin analogs treatment |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307122/ https://www.ncbi.nlm.nih.gov/pubmed/30591061 http://dx.doi.org/10.1186/s12902-018-0325-4 |
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