Curative treatment of pancreatic functioning insulinoma with stereotactic ablative radiation therapy: case report

Authors

  • Aws Abdulrahman Alsuhaibani Alfaisal University
  • Abdullah Abdulrahman Alsuhaibani King Saud University, King Khalid University Hospital, Oncology center, Radiation Oncology Unit, Riyadh, Saudi Arabia
  • Tareq Salah Hassan 2King Saud University, King Khalid University Hospital, Oncology center, Radiation Oncology Unit, Riyadh, Saudi Arabia 3Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt

DOI:

https://doi.org/10.18203/2349-2902.isj20215153

Keywords:

Insulinoma, Stereotactic radiation, SBRT, SABR, Radiation

Abstract

Insulinoma is the most common pancreatic neuroendocrine tumor (NET). It is a rare disease account for 1-2% of pancreatic tumors and affect approximately up to 3 patients per million per year. complete surgical resection or debulking are standard of care option. However, surgery is associated with short and long-term post-operative morbidity and may not be appropriate for all patients. In This case we present management and cure of a case of functioning insulinoma with stereotactic ablative radiosurgery in an unfit patient for surgery.

References

De Herder WW, Niederle B, Scoazec J-Y. Well-differentiated pancreatic tumor/carcinoma: insulinoma. Neuroendocrinology. 2006;84(3):183-8.

Okabayashi T, Shima Y, Sumiyoshi T. Diagnosis and management of insulinoma. World J Gastroenterol. 2013;19(6):829.

Bouslama K, Maghrebi H, Bedioui H, Bouslama KJJAHG. Pancreatic insulinoma: diagnostic approach and therapeutic modalities. BMC Res Notes. 2014;8:11-5.

Giannis D, Moris D, Karachaliou G-S. Insulinomas: from diagnosis to treatment. A review of the literature. J BUON. 2020;25(3):1302-14.

Metz DC, Jensen RTJG. Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors. Gastroenterology. 2008;135(5):1469-92.

Myrehaug S, Hallet J, Chu W. Proof of concept for stereotactic body radiation therapy in the treatment of functional neuroendocrine neoplasms. J Radiosurg SBRT. 2020;6(4):321.

De Herder WW, van Schaik E, Kwekkeboom D, Feelders RAJCe. New therapeutic options for metastatic malignant insulinomas. Mov Disord. 2011;75(3):277-84.

Zhao Yp, Zhan Hx, Zhang Tp. Surgical management of patients with insulinomas: result of 292 cases in a single institution. J Surg Oncol. 2011;103(2):169-74.

Baudin E, Caron P, Lombard-Bohas C. Malignant insulinoma: recommendations for characterisation and treatment. Ann Endocrinol (Paris). 2013;74(5-6):523-33.

Whipple AO, Frantz VKJAos. Adenoma of islet cells with hyperinsulinism: a review. Ann Surg. 1935;101(6):1299.

Nikfarjam M, Warshaw AL, Axelrod L. Improved contemporary surgical management of insulinomas: a 25-year experience at the Massachusetts General Hospital. Ann Surg. 2008;247(1):165.

Grant CSJBp, gastroenterology rC. Insulinoma. 2005;19(5):783-98.

Chan DL, Dixon M, Law CH. Outcomes of cytoreductive surgery for metastatic low-grade neuroendocrine tumors in the setting of extrahepatic metastases. Ann Surg Oncol. 2018;25(6):1768-74.

De Baere T, Deschamps F, Tselikas L. GEP-NETS update: Interventional radiology: role in the treatment of liver metastases from GEP-NETs. Eur J Endocrinol. 2015;172(4):R151-66.

Berelavichus SV, Kriger AG, Dugarova RS, Kaldarov ARJSCCM. Treatment of Insulinomas with Minimally Invasive Physical Procedure. Literature Review. 2019;1(2):104-12.

Ahmed KA, Caudell JJ, El-Haddad G. Radiosensitivity differences between liver metastases based on primary histology suggest implications for clinical outcomes after stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2016;95(5):1399-404.

Ghaly M, Gogineni E, Saif MWJP. The Evolving Field of Stereotactic Body Radiation Therapy in Pancreatic Cancer. Pancreas (Fairfax). 2019;3(1):9.

Leksell LJAcs. The stereotactic method and radiosurgery of the brain. Acta Chir Scand. 1951;102:316-9.

Blomgren H, Lax I, Näslund I, Svanström RJAo. Stereotactic high dose fraction radiation therapy of extracranial tumors using an accelerator: clinical experience of the first thirty-one patients. Acta Oncol. 1995;34(6):861-70.

Videtic GM, Chang JY, Chetty IJ. ACR Appropriateness Criteria® Early-Stage Non-Small-Cell Lung Cancer. Am J Clin Oncol. 2014;37(2):201-7.

Kollar L, Rengan R. Stereotactic body radiotherapy. Paper presented at: Seminars in oncology. 2014.

Pollom EL, Alagappan M, Von Eyben R. Single-versus multifraction stereotactic body radiation therapy for pancreatic adenocarcinoma: outcomes and toxicity. Int J Radiat Oncol Biol Phys. 2014;90(4):918-25.

Koong AC, Le QT, Ho A. Phase I study of stereotactic radiosurgery in patients with locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys. 2004;58(4):1017-21.

Goodman KA, Koong AC. 26 Cyber Knife Radiosurgery for Pancreatic Cancer. 2005.

Huscher CGS, Mingoli A, Sgarzini G, Mereu A, Gasperi MJSi. Image-guided robotic radiosurgery (Cyber Knife) for pancreatic insulinoma: is laparoscopy becoming old? Surg Innov. 2012;19(1):NP14-7.

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Published

2021-12-28

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Section

Case Reports