Management of intractable hypoglycemia with Yttirum-90 radioembolization in a patient with malignant insulinoma

Am J Med Sci. 2010 Nov;340(5):414-7. doi: 10.1097/MAJ.0b013e3181ee7be2.


Metastatic insulinomas may present with recurrent life-threatening hypoglycemia. Treatment of hypoglycemia in such patients is difficult and frequently fails to respond to numerous therapeutic agents, requiring continuous dextrose infusion. The authors present our experience with Yttirum-90 radioembolization in a patient with metastatic malignant insulinoma who failed to respond to distal pancreatectomy, systemic chemotherapy with capecitabine and everolimus and medical treatment with somatostatin analogues, diazoxide and corticosteroids. Treatment with repeated Y-90 radioembolization resulted in rapid resolution of hypoglycemic events, allowing discontinuation of dextrose infusion and hospital discharge. However, the effect of Y-90 administration seems to be transient and without evidence of tumor shrinkage in imaging studies.

Publication types

  • Case Reports

MeSH terms

  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Hypoglycemia / diagnostic imaging*
  • Hypoglycemia / etiology
  • Hypoglycemia / pathology
  • Hypoglycemia / surgery*
  • Insulinoma / complications
  • Insulinoma / diagnostic imaging*
  • Insulinoma / pathology
  • Insulinoma / surgery*
  • Liver Neoplasms / secondary
  • Middle Aged
  • Pancreatectomy
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / surgery*
  • Radionuclide Imaging
  • Yttrium Radioisotopes / therapeutic use


  • Yttrium Radioisotopes