Hepatic long-term metastatic malignant insulinoma: one case report and literature review / 中华内分泌代谢杂志

ABSTRACT

This article reported a case of malignant insulinoma which recurred as liver metastasis 12 years after the initial pancreatic insulinoma resection. The patient was a 48-year-old woman who was firstly diagnosed as pancreatic insulinoma in 2006 and underwent the surgery involved complete resection of a 1.9 cm×1.3 cm tumor located in pancreas. No signs of either invasion or metastasis was detected according to preoperative imaging examination and intraoperative exploration. The tumor was diagnosed as a benign insulinoma according to histopathological results. The patient had no hypoglycemia and the fasting blood glucose was normal during the subsequent 12 years. The patient underwent a fasting blood glucose of 2.8 mmol/L in 2018, and gradually experienced palpitation and cold sweats, which was relieved by eating. She was hospitalized in May 2018 with blood glucose of 1.73 mmol/L and insulin of 1 128 pmol/L. CT and MRI revealed morphologic changes of postoperative pancreas and abnormal liver signal, the liver tumor was finally identified as insulinoma by modified selective intra-arterial calcium stimulated venous sampling (ASVS). Partial liver resection was performed and the histopathological result was neuroendocrine tumor. Therefore, the disease was diagnosed as liver metastatic malignant insulinoma.