Intra-arterial liver chemotherapy and hormone therapy in malignant insulinoma: Case report and review of the literature

Background: Malignant insulinoma is a rare tumor, Metastatic disease confined to the liver can be treated with various coregional treatments. Case report: We report a case of a young woman who developed liver metastases twelve years following resection of a pancreatic insulinoma positive to anti-insulin antibodies. With five cycles of intra-arterial locoregional chemotherapy (fluorouracil and epirubicin) to the liver and monthly hormone therapy (octreotide) the patient obtained a clinical complete response. After twelve months she is still disease free. Conclusion: Locoregional therapy for insulinoma metastatic to the liver might represent the treatment of choice; hepatic intra-arterial chemotherapy is an interesting therapeutic approach which deserves attention, The role of somatostatin analogs is limited to symptom control.