Successful arterial embolization of an insulinoma.

A 38-year-old woman had fasting hypoglycemia, hyperinsulinemia, and an arteriographically demonstrable insulinoma. One year after surgical resection, however, hypoglycemia recurred and an arteriogram demonstrated a recurrent intrapancreatic vascular mass. Because of anticipated complications of another surgical approach, we elected to embolize the tumor arteriographically, using microfibrillar collagen. The patient's fasting blood glucose and insulin levels improved rapidly. Eleven months after embolization, the patient remains well, with normal blood glucose levels.