Islet-cell Carcinoma Treated with Alloxan

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Abstract
The case of a 46-year-old woman with hyperinsulinism is reported because of several unusual features. The clinical picture was characteristic of a functioning tumor of pancreatic islet beta cells but on X-ray examination of the abdomen irregular calcification was seen in the region of the pancreas and multiple spherical calcific masses were present throughout the enlarged liver. At laparotomy, a calcified islet-cell carcinoma was found. The primary tumor was not resectable. Multiple metastases in the liver accounted for the spherical calcifications. Insulin-producing tumors have calcified in other reported cases but calcification of their hepatic metastases is heretofore unreported. Significant improvement in hypoglycemic symptoms for more than 2 years followed the rapid intravenous administration of alloxan. Previous attempts to treat hyperinsulinism with alloxan have usually been disappointing. The rapid development of thyrotoxicosis with myopathy was associated with complete remission of hypoglycemia. After radioiodine therapy the manifestations of thyrotoxicosis subsided and the myopathy improved but hypoglycemic attacks again became severe. No etiologic relationship is recognized between the 2 endocrinopathies.