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<p>We report the case of a 62-year-old woman diagnosed in 2015 with de novo metastatic malignant insulinoma. She presented severe hypoglycemia and was initially treated with somatostatin analogs, chemotherapy (capecitabine-temozolomide), and diazoxide, but none of these controlled the symptoms. Peptide receptor radionuclide therapy (PRRT) with [<sup>177</sup>Lu]Lu-DOTATATE was initiated in 2016, resulting in marked clinical and radiological responses after four cycles. Due to recurrence, two subsequent PRRT treatments were administered in 2021 and 2024, each consisting of two cycles, leading to significant improvements in symptoms and imaging findings. To date, the patient has undergone eight PRRT cycles with sustained biochemical and morphological responses, long-term glycemic control, and excellent tolerance. This case illustrates the long-term efficacy of sequential PRRT retreatment in refractory functional pancreatic neuroendocrine tumors (pNETs).</p>

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A case report of enduring benefit of sequential PRRT in malignant insulinoma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月23日

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  • Cristina-An Wang Zhang,
  • Natacha Driessens,
  • Magdalena Mileva,
  • Amélie Deleporte,
  • Patrick Flamen,
  • Ioannis Karfis

摘要

We report the case of a 62-year-old woman diagnosed in 2015 with de novo metastatic malignant insulinoma. She presented severe hypoglycemia and was initially treated with somatostatin analogs, chemotherapy (capecitabine-temozolomide), and diazoxide, but none of these controlled the symptoms. Peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu-DOTATATE was initiated in 2016, resulting in marked clinical and radiological responses after four cycles. Due to recurrence, two subsequent PRRT treatments were administered in 2021 and 2024, each consisting of two cycles, leading to significant improvements in symptoms and imaging findings. To date, the patient has undergone eight PRRT cycles with sustained biochemical and morphological responses, long-term glycemic control, and excellent tolerance. This case illustrates the long-term efficacy of sequential PRRT retreatment in refractory functional pancreatic neuroendocrine tumors (pNETs).