In two patients islet cell tumors occurred in association with MEN type I, one of them benign and the other malignant. Patients with increasing weight had benign tumors. The 24 hours fasting test was not done in patients with malignant tumors because of the severity of hypoglycemia. The imaging studies showed that three patients with malignant tumors had hepatic metastasis and one had lymph node metastasis. Malignant insulinomas are more aggressive and the delay of diagnosis is shorter that in cases with benign tumors.
Selective arteriography remains the best preoperative localization procedure.
Saltz LB TI - Failure to confirm major objective antitumor activity for streptozocin and doxorubicin in the treatment of patients with advanced islet cell carcinoma. The combination regimen of streptozocin plus doxorubicin is the current standard chemotherapeutic treatment of symptomatic or progressing metastatic islet cell carcinoma. Sixteen such patients treated between February 1992 and February 1998 were identified. Their clinical characteristics, sites of measurable disease, response to treatment, time to treatment failure, and survival status were reviewed. All patients were treated with the starting doses as outlined by the published cooperative group report.