Pancreatic islet cell tumors metastatic to the liver: treatment by hepatic artery chemo-embolization.

The embolization of hepatic metastases of pancreatic islet cell tumors achieves a tumor necrosis without liver failure owing to double hepatic blood supply. The arterial chemotherapy performed at the same time delivers a large amount of cytotoxic agent directly into the tumor. Tumor bulk reducing and decreasing of production of pharmacologically active substances may be obtained to some degree. Although an objective documentation of the therapeutic effect is difficult to obtain, several series emphasize that the embolization provides a partial and transient palliative remission. Therefore, the chemo-embolization should be included in a multidisciplinary approach of metastatic endocrine malignancies in combination with surgical resection, systemic antineoplastic chemotherapy, and antihormonal therapy.