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

Insulinoma is an insulin-producing pancreatic neuroendocrine tumor that can be malignant in about 10% of cases. Locoregional invasion, lymph node metastases, or remote metastases are the main criteria of malignant insulinoma. Its incidence in patients with pre-existing diabetes mellitus (DM) is exce...

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Main Authors: Marco Ciacciarelli, Gianluca Caruso, Marco Rengo, Piero Maceroni, Carmen Misurale, Eleonora D’Armiento, Alessandro Polidoro, Cristina Napoli, Alberto Lombardini, Umberto Ceratti, Ruben Manuel Luciano Colunga Biancatelli, Leonardo Calvosa, Romina Milanese, Sonia Ferri, Teresa Massaro, Andrea Lorusso, Veronica Sorrentino, Vincenzo Petrozza, Luigi Iuliano
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Endocrinology
Online Access:http://dx.doi.org/10.1155/2020/4239679
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author Marco Ciacciarelli
Gianluca Caruso
Marco Rengo
Piero Maceroni
Carmen Misurale
Eleonora D’Armiento
Alessandro Polidoro
Cristina Napoli
Alberto Lombardini
Umberto Ceratti
Ruben Manuel Luciano Colunga Biancatelli
Leonardo Calvosa
Romina Milanese
Sonia Ferri
Teresa Massaro
Andrea Lorusso
Veronica Sorrentino
Vincenzo Petrozza
Luigi Iuliano
author_facet Marco Ciacciarelli
Gianluca Caruso
Marco Rengo
Piero Maceroni
Carmen Misurale
Eleonora D’Armiento
Alessandro Polidoro
Cristina Napoli
Alberto Lombardini
Umberto Ceratti
Ruben Manuel Luciano Colunga Biancatelli
Leonardo Calvosa
Romina Milanese
Sonia Ferri
Teresa Massaro
Andrea Lorusso
Veronica Sorrentino
Vincenzo Petrozza
Luigi Iuliano
author_sort Marco Ciacciarelli
collection DOAJ
description Insulinoma is an insulin-producing pancreatic neuroendocrine tumor that can be malignant in about 10% of cases. Locoregional invasion, lymph node metastases, or remote metastases are the main criteria of malignant insulinoma. Its incidence in patients with pre-existing diabetes mellitus (DM) is exceptionally rare. In this report, we describe a 66-year-old man with long-standing type 2 DM who presented with recurrent episodes of diaphoresis due to severe hypoglycemia despite the withdrawal of insulin therapy, hypercalcitoninemia, and biochemical and radiological findings suggestive of metastatic malignant insulinoma. Unfortunately, after few days of diazoxide treatment, edema, hypotension, oliguria, and water retention were observed, patient’s clinical status deteriorated rapidly, and he died in our department from acute renal failure.
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spelling doaj-art-38092f9038bd4b77aee17dcd59e56e332025-08-20T03:20:29ZengWileyCase Reports in Endocrinology2090-65012090-651X2020-01-01202010.1155/2020/42396794239679Malignant Insulinoma with Multiple Liver Metastases and Hypercalcitoninemia in a Patient with Type 2 Diabetes Mellitus Presenting as Recurrent Episodes of Diaphoresis due to Severe HypoglycemiaMarco Ciacciarelli0Gianluca Caruso1Marco Rengo2Piero Maceroni3Carmen Misurale4Eleonora D’Armiento5Alessandro Polidoro6Cristina Napoli7Alberto Lombardini8Umberto Ceratti9Ruben Manuel Luciano Colunga Biancatelli10Leonardo Calvosa11Romina Milanese12Sonia Ferri13Teresa Massaro14Andrea Lorusso15Veronica Sorrentino16Vincenzo Petrozza17Luigi Iuliano18Department of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Pathology Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Radiological Sciences, Oncology and Pathology, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Radiological Sciences, Oncology and Pathology, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Pathology Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Pathology Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyDepartment of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, “Sapienza” University of Rome, Via Franco Faggiana 1668, Latina 04100, ItalyInsulinoma is an insulin-producing pancreatic neuroendocrine tumor that can be malignant in about 10% of cases. Locoregional invasion, lymph node metastases, or remote metastases are the main criteria of malignant insulinoma. Its incidence in patients with pre-existing diabetes mellitus (DM) is exceptionally rare. In this report, we describe a 66-year-old man with long-standing type 2 DM who presented with recurrent episodes of diaphoresis due to severe hypoglycemia despite the withdrawal of insulin therapy, hypercalcitoninemia, and biochemical and radiological findings suggestive of metastatic malignant insulinoma. Unfortunately, after few days of diazoxide treatment, edema, hypotension, oliguria, and water retention were observed, patient’s clinical status deteriorated rapidly, and he died in our department from acute renal failure.http://dx.doi.org/10.1155/2020/4239679
spellingShingle Marco Ciacciarelli
Gianluca Caruso
Marco Rengo
Piero Maceroni
Carmen Misurale
Eleonora D’Armiento
Alessandro Polidoro
Cristina Napoli
Alberto Lombardini
Umberto Ceratti
Ruben Manuel Luciano Colunga Biancatelli
Leonardo Calvosa
Romina Milanese
Sonia Ferri
Teresa Massaro
Andrea Lorusso
Veronica Sorrentino
Vincenzo Petrozza
Luigi Iuliano
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
Case Reports in Endocrinology
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
url http://dx.doi.org/10.1155/2020/4239679
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