Malignant insulinoma which expressed a unique creatine kinase isoenzyme: Clinical value of arterial embolization as a palliative therapy

A 76-year-old man with hypoglycemic coma was diagnosed as malignant insulin oma with multiple hepatic metastases, Embolization was done for two-thirds of the hepatic mass and it rapidly lowered the serum immunoreactive insulin . He was discharged without medication and has been free from hypoglycemia. After the embolization, the serum creatine kinase (CK) level increased tra nsiently although there was no evidence of myocardial infarction, On electr ophoresis, the CK activity showed an abnormal peak, suggesting mitochondria l CK, CK release after embolization has been reported in only a few cases w ith endocrine tumors, which might indicate some relationship between active energy metabolism and mitochondrial CK.