Table 1.
Clinical characteristics of the 15 patients with malignant insulinoma
| Noc. | Gender | Age at diagnosis | Hypoglycemia time | GLU (mmol/L) | INS (μIU/mL) | C-P (ng/mL) | Number and diameter (cm) of primary lesions | Location of primary lesionsa | Local infiltration | Sites and numbers of metastases | Treatment after metastasis occurrence | Prognosis | Follow-up duration (years)b |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | F | 54 | Fasting, before meals | 1.4 | 32.05 | 5.6 | 1, 5 × 5 | Head | Yes | Multiple liver metastases | TACE for 1 course | N. A. | Loss to follow-up |
| 2 | F | 63 | Fasting | 1.3 | 81.41 | 3.9 | 1, 1.8 × 1.4 | Neck | No | Multiple pulmonary metastases, bone metastases? | Automatic discharge | No symptoms of hypoglycemia | Survival (7 years) |
| 3 | M | 46 | Fasting | 1.6 | 62.52 | 5.2 | 1, 5.8 × 4.3 | Tail | Yes | Multiple liver and lymph nodes metastases | Somatostatin analogues for 9 courses | Alleviation of hypoglycemia | Loss to follow-up |
| 4 | M | 51 | Before meals | 1.0 | N.Ad. | N.A. | 3, 3 × 4 | Tail | Yes | Multiple liver metastases | Distal pancreatectomy | No remission | Loss to follow-up |
| 5 | M | 26 | Fasting | 2.2 | 121.8 | N.A. | 1, 1.5 | Head | No | Multiple intracranial metastases | Pancreatic lesion enucleation | Blood glucose increased, still in a coma | Loss to follow-up |
| 6 | F | 30 | Before meals | 1.0 | 300 | 7.9 | 1, 0.9 | Body | No | Multiple liver and lymph nodes metastases | Enucleation with partial hepatectomy, Sandostatin LAR for 2 courses | No hypoglycemia | Survival (0.8 years) |
| 7 | M | 55 | Fasting | 1.9 | 148 | N.A. | 1, 6 | Tail | Yes | Multiple liver metastases | Exploratory laparotomy, TACE for 1 course | N.A. | Loss to follow-up |
| 8 | F | 39 | Fasting, after meals and exercise | 1.9 | 15.2 | 2.9 | 1, N.A. | Head | No | Multiple liver metastases | pancreatic surgery (unspecified) | No hypoglycemia | Survival (14 years) |
| 9 | M | 72 | Fasting, before meals | 2.3 | 29.48 | 2.7 | 1, 1.5 | Head | No | Solitary liver metastases | Surgical resection of liver metastases | No remission | Survival (4 years) |
| 10 | F | 39 | Before meals | 1.5 | 42.2 | 2.5 | 1, 1.2 | Head | No | Multiple liver metastases | Exploratory laparotomy, absolute ethanol injection ablation for 3 courses, TACE for 10 courses | Temporary remission | Survival (13 years) |
| 11 | M | 40 | Fasting | 2.9 | 5.2 | 0.6 | 1, 0.8 × 1 | Head | No | Multiple liver metastases | Sandostatin LAR for 2 courses | No remission | Loss to follow-up |
| 12 | F | 50 | Fasting, before meals, after exercise | 1.9 | 300 | 21.61 | 1, N.A. | N.A. | No | Multiple liver metastases | Liver interventional therapy for 4 courses, liver surgery (unspecified) | No hypoglycemia | Survival (6 years) |
| 13 | M | 38 | Fasting, after exercise | 2.1 | N.A. | N.A. | 1, 1 | Tail | No | Solitary liver metastases | Surgical resection of liver metastases | No hypoglycemia | Loss to follow-up |
| 14 | M | 36 | Fasting | 0.9 | 17 | 3.7 | 1, N.A. | Neck | No | Multiple liver metastases | Exploratory laparotomy, TACE for 1 courses | N.A. | Loss to follow-up |
| 15 | F | 38 | Fasting, before meals | 1.6 | 71.8 | 7.3 | 1, 6 × 4 | Tail | No | Multiple liver metastases | TACE for 4 courses | 3 years of remission | Loss to follow-up |
aLocation of primary lesions: final determination was based on preoperative mapping and intraoperative positioning
bSurvival duration: the period between metastasis occurrence and follow-up visits
cCase Nos. 1–8 had developed metastasis upon diagnosis, whereas case Nos. 9–15 developed metastasis during the follow-up visits
dN.A., data not available