Metastatic islet cell tumour with clinical manifestations of insulin and glucagon excess: successful treatment by hepatic artery embolization and chemotherapy.

A patient with a metastatic islet cell tumour with clinical features of both insulin and glucagon excess is reported. This appears to be only the third such case in the literature and the first in whom the initial symptoms were of the glucagonoma syndrome. Radiologically and biochemically defined complete remission was induced within 9 months of hepatic arterial embolization and cyclical chemotherapy with 5-fluorouracil and streptozocin; complete remission has been maintained for a further 23 months without therapy.