Long-Term Effect of 177Lu-Dotatate on Severe and Refractory Hypoglycemia Associated with Malignant Insulinoma

Pedro Iglesias, MD; Alberto Martínez, MD; Pablo Gajate, MD; Teresa Alonso, MD; Teresa Navarro, MD; Juan J. Díez, MD

AACE Clinical Case Reports (Nov 2019)

Long-Term Effect of 177Lu-Dotatate on Severe and Refractory Hypoglycemia Associated with Malignant Insulinoma

Pedro Iglesias, MD,
Alberto Martínez, MD,
Pablo Gajate, MD,
Teresa Alonso, MD,
Teresa Navarro, MD,
Juan J. Díez, MD

Affiliations

Pedro Iglesias, MD: Address correspondence to Dr. Pedro Iglesias, Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain.; From the Departments of Endocrinology, Madrid, Spain; Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Address correspondence to Dr. Pedro Iglesias, Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain.
Alberto Martínez, MD: Nuclear Medicine, Madrid, Spain
Pablo Gajate, MD: Medical Oncology, Hospital Ramón y Cajal, Madrid, Spain
Teresa Alonso, MD: Medical Oncology, Hospital Ramón y Cajal, Madrid, Spain
Teresa Navarro, MD: Nuclear Medicine, Madrid, Spain
Juan J. Díez, MD: From the Departments of Endocrinology, Madrid, Spain; Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.

Journal volume & issue: Vol. 5, no. 6
pp. e330 – e333

Abstract

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ABSTRACT: Objective: Malignant insulinoma is an extremely uncommon tumor that is usually accompanied by severe hypoglycemia that is difficult to manage. At this time, the long-term effect of 177Lu-DOTATATE (lutetium [Lu-177]-DOTA-Tyr3-octreotate) on this tumor is not well known. Methods: We report a case of severe, life-threatening, and refractory hypoglycemia associated with malignant insulinoma treated with 177Lu-DOTATATE. Results: A 51-year-old woman was referred because of severe, life-threatening, and refractory hypoglycemia due to malignant insulinoma. The patient had been treated unsuccessfully with chemotherapy, targeted therapies, and symptomatic therapy with diazoxide, steroids, and somatostatin analogues without success. 177Lu-DOTATATE adequately controlled her hypoglycemia after the other conventional treatments failed. Conclusion: 177Lu-DOTATATE was effective in providing rapid and long-term symptomatic control of the hypoglycemia and significantly improved the quality of life of the patient.

Published in AACE Clinical Case Reports

ISSN: 2376-0605 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://www.journals.elsevier.com/aace-clinical-case-reports

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