Transformation of Nonfunctioning Pancreatic Neuroendocrine Carcinoma Cells into Insulin Producing Cells after Treatment with Sunitinib
Endocrinology and Metabolism
;
: 149-152, 2013.
Article
in English
| WPRIM
| ID: wpr-119437
ABSTRACT
We report a rare case of severe hypoglycemia after sunitinib treatment for pancreatic neuroendocrine carcinoma. We describe the initial clinical presentation, laboratory results, pathologic findings, and managment in a patient with a nonfunctioning pancreatic neuroendocrine carcinoma with liver metastases who developed life threatening hypoglycemia after 2 months of sunitinib therapy. A 46-year-old woman presented to the emergency department with loss of consciousness from hypoglycemia. Serum C-peptide and insulin levels at fasting state revealed that the hypoglycemia resulted from endogenous hyperinsulinemia. She had been diagnosed with nonfunctioning pancreatic neuroendocrine carcinoma based on a biopsy of metastatic cervical lymph node and was being treated with sunitinib, a small molecule tyrosine kinase inhibitor. Immunohistochemical stain of the metastatic liver mass demonstrated that the initially nonfunctioning neuroendocrine carcinoma cells had changed into insulin-producing cells after sunitinib therapy. Transarterial chemoembolization of the liver masses and systemic chemotherapy with streptozotocin/adriamycin relieved the hypoglycemia. A nonfunctioning pancreatic neuroendocrine carcinoma was transformed into an insulin-producing tumor after treatment with sunitinib, causing endogenous hyperinsulinemia and severe hypoglycemia.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pyrroles
/
Unconsciousness
/
Biopsy
/
Protein-Tyrosine Kinases
/
C-Peptide
/
Fasting
/
Carcinoma, Neuroendocrine
/
Emergencies
/
Hyperinsulinism
/
Hypoglycemia
Limits:
Female
/
Humans
Language:
English
Journal:
Endocrinology and Metabolism
Year:
2013
Type:
Article
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