Medical treatment of unresectable malignant insulinoma in an elderly patient

Abstract

An 86-year-old woman presented with loss of consciousness and had Whipple's triad. Enhanced abdominal computed tomography scan showed a pancreatic tumor and multiple liver tumors with hypervascularity. The patient was diagnosed with malignant insulinoma, with secretion from both lobes of the liver based on results of a 48-hour fasting test, and selective arterial secretagogue injection test. Somatostatin receptor scintigraphy was positive in the pancreatic tumor and multiple liver metastases. Surgical treatment was considered to be ineffective, and the patient was treated with somatostatin analog and diazoxide. Symptoms of hypoglycemia were diminished with this treatment. This approach can improve the quality of life for elderly patients with unresectable malignant insulinoma.