Treatment of malignant insulinoma with fluocortolone and high-dose folinic acid and 5-fluorouracil: Case report and review of the literature

Barutca S., Yilmaz U., Ustun H., Biberoglu S., Comlekci A., Topalak Ö. S., ...More

ENDOCRINOLOGIST, vol.12, no.2, 2002 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Review
  • Volume: 12 Issue: 2
  • Publication Date: 2002
  • Doi Number: 10.1097/00019616-200203000-00003
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Dokuz Eylül University Affiliated: Yes


Insulinoma is a rare islet cell tumor with typical clinical and biochemical characteristics caused by excessive insulin secretion. The malignant form is characterized by metastases for which a curative resection is rarely possible. Chemotherapy is usually ineffective. We achieved control of serum glucose levels with fluocortolone in a patient with malignant insulinoma and hypoglycemia. We then administered high dose folinic acid and 5-fluorouracil (5-FU) bolus, then 5-FU by continuous in, fusion for 2 consecutive days every 2 weeks (this method is abbreviated as HDLV5FU). The plasma insulin and C-peptide levels remained unchanged and the neoplasm was stable for 4 months with this therapy. According to the authors' literature review, this is the first malignant insulinoma case treated with both fluocortolone and HDLV5FU. Prospective studies are needed to determine more effective treatment modalities for malignant insulinoma.