Successful medical management of insulinoma with diazoxide for 27 years

Annabelle M Warren; Duncan J Topliss; Peter Shane Hamblin

doi:10.1530/EDM-20-0132

Successful medical management of insulinoma with diazoxide for 27 years

Endocrinol Diabetes Metab Case Rep. 2020 Oct 6:2020:20-0132. doi: 10.1530/EDM-20-0132. Online ahead of print.

Authors

Annabelle M Warren¹, Duncan J Topliss^{1

2}, Peter Shane Hamblin^{1

2

3

4}

Affiliations

¹ Department of Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria, Australia.
² Monash University, Central Clinical School, Melbourne, Victoria, Australia.
³ Department of Endocrinology and Diabetes, Western Health, Melbourne, Victoria, Australia.
⁴ Department of Medicine, Western Clinical School, The University of Melbourne, Melbourne, Victoria, Australia.

Abstract

Summary: Despite improvements in localisation techniques and surgical advances, some patients with insulinoma will not be cured by surgery or may not be suitable for surgery. Medical management with diazoxide is an option for such cases. This case report details 27 years of successful management of insulinoma using diazoxide. It has been effective and safe, with only minor adverse effects.

Learning points: Long term diazoxide use can be a safe, effective option for insulinoma when it cannot be localised or removed surgically. Common adverse effects include peripheral oedema, hyperuricaemia, and hirsutism. 68Ga-NOTA-exendin-4 PET/CT scan should be considered for insulinoma localisation when other modalities have been unhelpful.