Bozkirli Emre, Bakiner Okan, Abali Huseyin, Andic Cagatay, Yapar Ali Fuat, Kayaselcuk Fazilet, Ertorer Eda
Division of Endocrinology and Metabolism, Adana Medical Center, Baskent University School of Medicine, Dadaloglu Mah. Serin Evler 39, Sok. No. 6 Yuregir, 01250 Adana, Turkey.
Case Rep Endocrinol. 2013;2013:636175. doi: 10.1155/2013/636175. Epub 2013 May 8.
Metastatic insulinomas may sometimes present with recurrent life-threatening hypoglycemia episodes. Such patients usually fail to respond to various therapeutic agents which causes constant dextrose infusion requirement. Herein, we present a resistant case of inoperable malignant insulinoma who was treated with many therapeutic agents and interventions including somatostatin analogues, Yttrium-90 radioembolization, everolimus, radiotherapy, and chemoembolization. Close blood sugar monitorization during these therapies showed the most favourable response with everolimus. Everolimus treatment resulted in rapid improvement of hypoglycemia episodes, letting us discontinue dextrose infusion and discharge the patient. However, experience with everolimus in such patients is still limited, and more precise data can be obtained with the increasing use of this agent for neuroendocrine tumours.
转移性胰岛素瘤有时可能会出现反复发作的危及生命的低血糖发作。这类患者通常对各种治疗药物无反应，因此需要持续输注葡萄糖。在此，我们报告一例无法手术切除的恶性胰岛素瘤耐药病例，该患者接受了多种治疗药物和干预措施，包括生长抑素类似物、钇-90放射性栓塞、依维莫司、放疗和化疗栓塞。在这些治疗过程中密切监测血糖发现，依维莫司的反应最为良好。依维莫司治疗使低血糖发作迅速改善，使我们能够停止葡萄糖输注并让患者出院。然而，依维莫司在这类患者中的应用经验仍然有限，随着该药物在神经内分泌肿瘤中的使用增加，可以获得更精确的数据。
