Agata Matej, Hanna Bujwid, Jakub Wroński
Insulinoma is the most common neuroendocrine tumor of the pancreas. Surgical management of insulinomas is considered to be the only curative method. However, effective glycemic control preoperatively and in unresectable insulinomas remains a significant issue …
Grigorios Rombopoulos, Magdalini Hatzikou, Dimitra Latsou, John Yfantopoulos
OBJECTIVE: To estimate the impact of hypoglycemia on the Quality of Life (QoL) and its prevalence in patients with type 2 diabetes mellitus (T2DM) in Greece. DESIGN: A cross-sectional epidemiological study was conducted in 6631 patients with T2DM …
Vassiliki Syriou, Anestis Moisidis, Nikolaos Tamouridis, Krystallenia I. Alexandraki, Margarita Anapliotou
We present a 73-year-old man with isolated adrenocorticotropic hormone deficiency and “flexion contractures” syndrome along with a review of the relevant literature. The patient initially presented anorexia, vomiting, arthralgias, malaise, and weight loss, which progressively deteriorated during the subsequent 6 months. He was admitted to the hospital with fever, confusion, severe cachexia, sinus tachycardia, low blood pressure …
George N. Zografos, Alexandra Stathopoulou, George Mitropapas, John Karoubalis, George Kontogeorgos, Gregory Kaltsas, George Piaditis, George I. Papastratis
We report a case of an insulinoma that was not identified on either Computerized Tomography (CT) scan and Magnetic Resonance Imaging (MRI). Endoscopic ultrasonography (EUS) revealed a small insulinoma located at the body of the pancreas, which was histologically confirmed. The patient underwent a laparotomy but no tumour was identified either on palpation or with intra-operative ultrasound …
Mia Morgan, Alexandra Nanzer, Cecilia Camacho-Hubner, Gregory A. Kaltsas, John P. Monson
A patient presented with frequent episodes of spontaneous hypoglycaemia due to a disseminated neuroendocrine tumour with sarcomatous differentiation, secreting incompletely processed pro-insulin-like growth factor II (pro-IGF-II). Although the combination of GH and glucocorticoid therapy initially controlled the hypoglycaemia …
Athanasios Fountas, Stelios Tigas, Zoe Giotaki, Dimitrios Petrakis, George Pentheroudakis, Agathocles Tsatsoulis
OBJECTIVE: Sunitinib is a tyrosine kinase inhibitor used in the therapy of pancreatic neuroendocrine tumors (PNETs), metastatic renal cancer and gastrointestinal stromal tumors. We describe a patient with PNET who presented with severe hypoglycemia following sunitinib administration …
Stelios Fountoulakis, Dimosthenis Malliopoulos, Labrini Papanastasiou, Theodora Pappa, George Karydas, George Piaditis
OBJECTIVE: Non-insulinoma pancreatogenous hypoglycemia syndrome (NIPHS) is one of the rare causes of endogenous hyperinsulinism. Its diagnosis is challenging and may require selective intraarterial calcium stimulation and concomitant hepatic vein sampling (SACVS). Impaired counterregulatory hormones’ production in response to hypoglycemia …
Amit Tirosh, Salomon M. Stemmer, Evgeny Solomonov, Eldad Elnekave, Wolfgang Saeger, Yelena Ravkin, Kobi Nir, Yeela Talmor, Ilan Shimon
Malignant insulinoma usually has a poor prognosis, as no efficient medical treatment is available. The somatostatin analogs octreotide and lanreotide have limited ability to control the hypoglycemic events. Pasireotide is a multi-receptor targeted somatostatin-analog with improved affinity for SSTR5. There is to date no reported treatment experience with this drug in such tumors …