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Case Reports in Endocrinology
Volume 2013, Article ID 636175, 6 pages
http://dx.doi.org/10.1155/2013/636175
Case Report

A Case of Inoperable Malignant Insulinoma with Resistant Hypoglycemia Who Experienced the Most Significant Clinical Improvement with Everolimus

1Division of Endocrinology and Metabolism, Adana Medical Center, Baskent University School of Medicine, Dadaloglu Mah. Serin Evler 39, Sok. No. 6 Yuregir, 01250 Adana, Turkey
2Division of Medical Oncology, Adana Medical Center, Baskent University School of Medicine, Dadaloglu Mah. Serin Evler 39, Sok. No. 6 Yuregir, 01250 Adana, Turkey
3Division of Radiology, Adana Medical Center, Baskent University School of Medicine, Dadaloglu Mah. Serin Evler 39, Sok. No. 6 Yuregir, 01250 Adana, Turkey
4Division of Nuclear Medicine, Adana Medical Center, Baskent University School of Medicine, Dadaloglu Mah. Serin Evler 39, Sok. No. 6 Yuregir, 01250 Adana, Turkey
5Division of Pathology, Adana Medical Center, Baskent University School of Medicine, Dadaloglu Mah. Serin Evler 39, Sok. No. 6 Yuregir, 01250 Adana, Turkey

Received 10 March 2013; Accepted 12 April 2013

Academic Editors: M. Demura, O. Isozaki, and T. Usui

Copyright © 2013 Emre Bozkirli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.