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Table 1 Clinical characteristics of the 15 patients with malignant insulinoma

From: Clinical Management of Malignant Insulinoma: a single Institution’s experience over three decades

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

  1. aLocation of primary lesions: final determination was based on preoperative mapping and intraoperative positioning
  2. bSurvival duration: the period between metastasis occurrence and follow-up visits
  3. cCase Nos. 1–8 had developed metastasis upon diagnosis, whereas case Nos. 9–15 developed metastasis during the follow-up visits
  4. dN.A., data not available