PMID- 20164213
OWN - NLM
STAT- MEDLINE
DCOM- 20100507
LR  - 20191210
IS  - 1479-683X (Electronic)
IS  - 0804-4643 (Linking)
VI  - 162
IP  - 5
DP  - 2010 May
TI  - Therapies for the medical management of persistent hypoglycaemia in two cases of 
      inoperable malignant insulinoma.
PG  - 1001-8
LID - 10.1530/EJE-09-1010 [doi]
AB  - OBJECTIVE: Hypoglycaemia poses a significant management challenge in patients 
      with unresectable functional malignant insulinoma. Novel agents such as mammalian 
      target of rapamycin (mTOR) inhibitors and radiolabelled peptides may be effective 
      where there is failure of conventional therapy. DESIGN: We present the cases of 
      two men diagnosed with inoperable malignant insulinoma and hepatic metastases who 
      developed severe symptomatic hypoglycaemia, and review potential therapies for 
      glycaemic support. METHOD: Despite treatment with diazoxide, frequent oral 
      carbohydrate, prednisolone and somatostatin analogue therapy, both men required 
      hospital admission for treatment with continuous i.v. dextrose. Both were treated 
      with Lutetium-177 octreotate. One man was also treated with everolimus, a mTOR 
      inhibitor. RESULT: Use of Lutetium-177 octreotate, and in one case everolimus, 
      successfully achieved normoglycaemia, facilitating safe discharge from hospital. 
      Both men also had regression in the size and number of hepatic metastases. 
      CONCLUSION: Lutetium-177 octreotate and everolimus are options for managing 
      hypoglycaemia due to unresectable malignant insulinoma when refractory to 
      conventional supportive therapies.
FAU - Ong, Gregory S Y
AU  - Ong GS
AD  - Department of Endocrinology and Diabetes, Fremantle Hospital and Health Service, 
      Fremantle, Western Australia, Australia.
FAU - Henley, David E
AU  - Henley DE
FAU - Hurley, David
AU  - Hurley D
FAU - Turner, J Harvey
AU  - Turner JH
FAU - Claringbold, Phillip G
AU  - Claringbold PG
FAU - Fegan, P Gerry
AU  - Fegan PG
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20100217
PL  - England
TA  - Eur J Endocrinol
JT  - European journal of endocrinology
JID - 9423848
RN  - 0 (Organometallic Compounds)
RN  - 0 (Radiopharmaceuticals)
RN  - 9HW64Q8G6G (Everolimus)
RN  - AE221IM3BB (lutetium Lu 177 dotatate)
RN  - RWM8CCW8GP (Octreotide)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Aged
MH  - Everolimus
MH  - Humans
MH  - Hypoglycemia/*drug therapy
MH  - Insulinoma/*drug therapy
MH  - Liver Neoplasms/secondary
MH  - Male
MH  - Middle Aged
MH  - Octreotide/*analogs & derivatives/therapeutic use
MH  - Organometallic Compounds/*therapeutic use
MH  - Pancreatic Neoplasms/*drug therapy
MH  - Radiopharmaceuticals/*therapeutic use
MH  - Sirolimus/*analogs & derivatives/therapeutic use
EDAT- 2010/02/19 06:00
MHDA- 2010/05/08 06:00
CRDT- 2010/02/19 06:00
PHST- 2010/02/19 06:00 [entrez]
PHST- 2010/02/19 06:00 [pubmed]
PHST- 2010/05/08 06:00 [medline]
AID - EJE-09-1010 [pii]
AID - 10.1530/EJE-09-1010 [doi]
PST - ppublish
SO  - Eur J Endocrinol. 2010 May;162(5):1001-8. doi: 10.1530/EJE-09-1010. Epub 2010 Feb 
      17.