BACKGROUND: Preventing @entity4053 is of vital importance and a major challenge in @entity1 with severe symptomatic @entity4053 related to @entity5 , but there is no consensus treatment. @entity1 : Five @entity1 with @entity5 were referred to our department for severe @entity4053 . At referral the five @entity1 were dependent on iv infusion of @entity413 solution. @entity1 1 had a locally invasive 5-cm @entity9608 , @entity1 2, 3 and 4 had multiple liver @entity3 and @entity1 5 had a 2.5-cm @entity788 with multiple liver and lung @entity3 . Before referral to our department, 4/5 @entity1 had been administered systemic chemotherapy and 3/5 therapeutic doses of radiolabeled @entity2390 without any benefit on blood @entity413 levels. Octreoscan scintigraphy was positive in 4 @entity1 ( @entity1 1-4). @entity6335 alone or combined with glucocorticoids had failed to control @entity4053 . Continuous sc administration of @entity2390 (up to 1500  g/day) resulted in normalization of blood @entity413 levels in @entity1 1. Chemoembolization of liver @entity3 normalized blood @entity413 levels in @entity1 2, minimized @entity4053 in @entity1 3 and 4, and normalized blood @entity413 levels in @entity1 5 when followed by subcutaneous administration of @entity2390 (2000  g/day). Chemoembolization had to be repeated four times in @entity1 3 to control blood @entity413 levels. CONCLUSION: Chemoembolization of liver @entity3 and high-dose @entity2390 in responsive @entity1 (alone or combined with chemoembolization) can control severe @entity4053 in @entity1 with symptomatic @entity5 ; the efficacy of @entity2390 can be improved after chemoembolization of liver @entity3 .

Treatment with somatostatin analogs and chemoembolization of liver XXXX for severe @entity4053 in @entity5 .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PATIENTS', 'Patient'] @entity788 :: ('MESH:D010190', 'Disease') :: ['pancreatic tumor'] @entity9608 :: ('MESH:D007340', 'Disease') :: ['insulinoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['malignant unresectable insulinomas'] @entity6335 :: ('MESH:D003981', 'Chemical') :: ['Diazoxide'] @entity4053 :: ('MESH:D007003', 'Disease') :: ['hypoglycemia'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity2390 :: ('MESH:D015282', 'Chemical') :: ['octreotide'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose']
@entity3 :: (MESH:D009362,Disease) :: ['metastases']
