Radiofrequency Ablation as a Primary Therapy for Benign Functioning Insulinoma
Objective: Insulinomas are rare, life-threatening pancreatic neuroendocrine tumors. Surgical removal continues to be the treatment of choice, yet it is associated with considerable risk of morbidity. Here, we describe our patient with insulinoma who was successfully treated with radiofrequency ablat...
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doaj-b6bd4771d0eb4129ae14d936047462902021-05-01T04:36:06ZengElsevierAACE Clinical Case Reports2376-06052021-03-0172153157Radiofrequency Ablation as a Primary Therapy for Benign Functioning InsulinomaEbtihal Y. Alyusuf, MBBS0Aishah A. Ekhzaimy, MD1Juan A. Rivera, MD2Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi ArabiaDivision of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia; Address correspondence and reprint requests to Dr Aishah A. Ekhzaimy, Department of Medicine, King Saud University Medical City, King Saud University, PO Box 2925, Riyadh 11461, Kingdom of Saudi Arabia.Division of Endocrinology & Metabolism, Department of Internal Medicine, McGill University Health Centre-Glen Site, Royal Victoria Hospital, MontrealObjective: Insulinomas are rare, life-threatening pancreatic neuroendocrine tumors. Surgical removal continues to be the treatment of choice, yet it is associated with considerable risk of morbidity. Here, we describe our patient with insulinoma who was successfully treated with radiofrequency ablation. Methods: The patient was a 56-year-old man with no history of diabetes mellitus. He presented with recurrent episodes of transient ischemic attacks and stroke over the last 3 years. Some changes in his behavior and memory were noticed by family members. During his hospital stay for the second transient ischemic attack, frequent hypoglycemia was documented, which was asymptomatic. Insulinoma was confirmed biochemically. Radiological findings were also compatible with pancreatic neuroendocrine tumor. Treatment modalities were explained to the patient. However, he strongly refused surgery. Meanwhile, he was admitted because of a stroke and concurrent hypoglycemia again. In view of his refusal of the surgical treatment and due to his presentation with acute stroke and high-risk status for surgery, radiofrequency ablation was finalized. Results: Radiofrequency ablation of the pancreatic tumor using 40.75 Gy over fractions was performed with a favorable outcome. The patient has achieved biochemical normalization and remained euglycemic during his follow- up. Computed tomography scan of the abdomen during follow-up showed a mild regression of the size of the tumor. Conclusion: This report shows a treatment challenge that required the use of an alternative treatment option other than the standard of care. It highlights the evolving evidence of radiofrequency as a therapeutic modality for patients with insulinoma.http://www.sciencedirect.com/science/article/pii/S2376060520310506insulinomapancreatic neuroendocrine tumorsradiofrequency ablation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ebtihal Y. Alyusuf, MBBS Aishah A. Ekhzaimy, MD Juan A. Rivera, MD |
spellingShingle |
Ebtihal Y. Alyusuf, MBBS Aishah A. Ekhzaimy, MD Juan A. Rivera, MD Radiofrequency Ablation as a Primary Therapy for Benign Functioning Insulinoma AACE Clinical Case Reports insulinoma pancreatic neuroendocrine tumors radiofrequency ablation |
author_facet |
Ebtihal Y. Alyusuf, MBBS Aishah A. Ekhzaimy, MD Juan A. Rivera, MD |
author_sort |
Ebtihal Y. Alyusuf, MBBS |
title |
Radiofrequency Ablation as a Primary Therapy for Benign Functioning Insulinoma |
title_short |
Radiofrequency Ablation as a Primary Therapy for Benign Functioning Insulinoma |
title_full |
Radiofrequency Ablation as a Primary Therapy for Benign Functioning Insulinoma |
title_fullStr |
Radiofrequency Ablation as a Primary Therapy for Benign Functioning Insulinoma |
title_full_unstemmed |
Radiofrequency Ablation as a Primary Therapy for Benign Functioning Insulinoma |
title_sort |
radiofrequency ablation as a primary therapy for benign functioning insulinoma |
publisher |
Elsevier |
series |
AACE Clinical Case Reports |
issn |
2376-0605 |
publishDate |
2021-03-01 |
description |
Objective: Insulinomas are rare, life-threatening pancreatic neuroendocrine tumors. Surgical removal continues to be the treatment of choice, yet it is associated with considerable risk of morbidity. Here, we describe our patient with insulinoma who was successfully treated with radiofrequency ablation. Methods: The patient was a 56-year-old man with no history of diabetes mellitus. He presented with recurrent episodes of transient ischemic attacks and stroke over the last 3 years. Some changes in his behavior and memory were noticed by family members. During his hospital stay for the second transient ischemic attack, frequent hypoglycemia was documented, which was asymptomatic. Insulinoma was confirmed biochemically. Radiological findings were also compatible with pancreatic neuroendocrine tumor. Treatment modalities were explained to the patient. However, he strongly refused surgery. Meanwhile, he was admitted because of a stroke and concurrent hypoglycemia again. In view of his refusal of the surgical treatment and due to his presentation with acute stroke and high-risk status for surgery, radiofrequency ablation was finalized. Results: Radiofrequency ablation of the pancreatic tumor using 40.75 Gy over fractions was performed with a favorable outcome. The patient has achieved biochemical normalization and remained euglycemic during his follow- up. Computed tomography scan of the abdomen during follow-up showed a mild regression of the size of the tumor. Conclusion: This report shows a treatment challenge that required the use of an alternative treatment option other than the standard of care. It highlights the evolving evidence of radiofrequency as a therapeutic modality for patients with insulinoma. |
topic |
insulinoma pancreatic neuroendocrine tumors radiofrequency ablation |
url |
http://www.sciencedirect.com/science/article/pii/S2376060520310506 |
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