Malignant insulinoma with metastasis to gallbladder and bone, accompanied by past history of peptic ulcer and hyperthyroidism

Abstract

A case of a malignant insulinoma in a 53-year-old female is presented. In 1973, the patient underwent caudal pancreatectomy for a malignant insulinoma. Ten years later, it was discovered that the insulinoma had spread to the bones. On admission for cholecystectomy because of a gallbladder polyp and gallstones, she often experienced hypoglycemic attacks, and both calcium and glucagon provocation tests elicited marked release of insulin. Selective angiography of the common hepatic artery showed a tumor blush near the hilum of the liver. Immunohistochemical staining of the gallbladder polyp and the bone tumors proved positive for insulin. Plasma levels of insulin and prolactin were abnormally high. The patient had also been treated for a perforated duodenal ulcer and hyperthyroidism. It is concluded that this may have been a case of a multiple endocrine neoplasia.

Surgical resection for hepatocellular carcinoma with metastasis to the gallbladder: Report of a case

“…16,17 The primary sites of the metastatic tumor of the gallbladder other than malignant melanoma are breast cancer, renal cell carcinoma, lung cancer, gastric cancer, and insulinoma of the pancreas. [18][19][20][21] Extrahepatic metastases of HCC are rather common. An autopsy series found the frequency of extrahepatic metastasis to be 64%.…”

Malignant Insulinoma with Multiple Liver Metastases and Hypercalcitoninemia in a Patient with Type 2 Diabetes Mellitus Presenting as Recurrent Episodes of Diaphoresis due to Severe Hypoglycemia

“…Locoregional invasion, lymph node metastases, or remote metastases are the main criteria of malignant insulinoma. Most patients with malignant insulinoma have lymph node or liver metastases [5][6][7], and only rare metastases in other sites such as bones [8,9], lungs [10], brain [11], ovaries [12,13], and gallbladder [14]. Liver metastases at presentation count for almost 60% of the patients with PNETs [2].…”

Cardiac Rhabdomyoma in an Adult Patient Presenting With Ventricular Arrhythmia

“…The reported tumors with a blush on angiography include renal cell carcinoma, hepatic carcinoid, hemangioma, meningioma, insulinoma, and paraganglionoma. [7][8][9][10][11][12] Reports of cardiac tumors with a blush on coronary angiography have previously been limited to hemangioma, myxoma, and pheochromocytoma. [13][14][15] We believe this is the first report of a cardiac rhabdomyoma with tumor blush on coronary angiography.…”