恶性胰岛素瘤多发肝转移一例OA北大核心CSTPCD

Malignant insulinoma is a kind of rare and challenging neuroendocrine tumor.It is often ac-companied by distant metastasis,among which liver metastasis is most common,and the prognosis is often non-promising.In this paper,we report a case of multiple liver metastases from malignant insulinoma.The pa-tient,a 70-year-old male,was admitted to the hospital due to"episodic consciousness disorder for more than four months."Blood glucose monitoring revealed recurrent hypoglycemia in the early morning,after meals,and at night.Pancreatic perfusion CT and dynamic enhanced MRI of the liver revealed a mass in the uncinate process of the pancreatic head and multiple liver metastases.Percutaneous liver biopsy confirmed the diagnosis of insulinoma.After multidisciplinary discussions,hepatic artery embolization and radiofrequency ablation were performed in stages,in combination with everolimus treatment.Thereafter,the enhanced CT demonstrated that some liver metastases shrank.The patient had regular meals,and the blood sugar gradually increased and re-mained normal thereafter.This article discusses this case's clinical characteristics and multidisciplinary collabo-rative diagnosis and treatment,aiming to provide experience for the comprehensive clinical diagnosis and treat-ment of malignant insulinoma patients.