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 confin ed to the liver can be treated with various coregional treatments. Case report: We report a case of a young woman who developed liver metastas es twelve years following resection of a pancreatic insulinoma positive to anti-insulin antibodies. With five cycles of intra-arterial locoregional ch emotherapy (fluorouracil and epirubicin) to the liver and monthly hormone t herapy (octreotide) the patient obtained a clinical complete response. Afte r twelve months she is still disease free. Conclusion: Locoregional therapy for insulinoma metastatic to the liver mig ht represent the treatment of choice; hepatic intra-arterial chemotherapy i s an interesting therapeutic approach which deserves attention, The role of somatostatin analogs is limited to symptom control.