Therapie Eines Metastasierenden Inselzelltumors Mit Streptozotocin

Abstract

A patient with a metastazing functional islet cell tumour suffering from severe hypoglycaemia was treated with streptozotocin. Four intravenous injections of 1.5 g streptozotocin each were administered in 4 to 6 days intervals. After the 4th injection there were no further episodes of hypoglycaemia, parenteral glucose administration could be stopped and blood sugar and plasma insulin, showing concentrations of up to 405 μU/ml before treatment, reached normal levels. The tumours in the pancreas disappeared and the liver metastases decreased in size and number as judged by arteriography. A hypothesis for the mechanism of action of streptozotocin is proposed. The glucose moiety is considered to facilitate a high affinity to the islet cells whereas the N-methyl-nitrosourea residue serves the active antitumour part of the molecule.

Biochemical and morphological investigations of 30 human insulinomas

“…One case was operated by Prof. E. Kern (Department of Surgery, University of Wiirzburg) and three by Prof. Berchtold (Department of Surgery, University of Bern). One patient with B-cell carcinoma previously published [37] has been operated by Prof. K. Kiimmerle (Department of Surgery, University of Mainz). Three cases have been studied preoperatively by Prof. Fankhauser and Dr. J. Michl (Department of Medicine, University of Bern).…”

Malignant Metastatic Insulinoma Treated With Streptozotocin

“…We have found in the general medical literature fourteen detailed case reports of metastatic insulinoma treated by streptozotocin (Arnold et al, 1969;Blackard et al, 1970;Cunningham et al, 1971;Murray-Lyon et al, 1968Neischlag et al, 1971;Sadoff, 1969;Schreibman et al, 1971;Smith et al, 1973;Stanley et al, 1970;Taylor et af., 1970;Vogel, 1971), while the Cancer Evaluation Branch of the National Cancer Institute had on record fifty-two such cases by the end of 1972 (Schein, 1972), about 80% of them hormone-secreting (Border & Carter, 1972). Of thirty-five cases with hormone-secreting tumours, about 80% responded to treatment, with an average remission period of 1 year.…”