TREATMENT OF METASTATIC INSULINOMAS

Malignant insulinomas are slow growing tumours for which the prognosis is worsened by metastatic disease and sequellae of excess hormone sec retion. Management of unresectable tumours includes intravenous chemot herapy and local treatments such as palliative surgery and transcathet er arterial embolization of liver metastases. Long-term survival can a lso be improved by inhibition of secretory products of the tumour with either octreotide, a somatostatin analogue, or diazoxide. We report t wo cases of malignant insulinomas with liver metastases for which obje ctive responses were obtained with combination of local treatment and intravenous chemotherapy.