Clinico-pathological features, treatments and survival of malignant insulinomas: A multicenter study: European Journal of Endocrinology

A. Veltroni, E. Cosaro, F. Spada, N. Fazio, A. Faggiano, A. Colao, S. Pusceddu, M.C. Zatelli, D. Campana, A. Piovesan, A. Pia, E.M. Grossrubatscher, A. Filice, A. Bianchi, P. Razzore, M. Toaiari, S. Cingarlini, L. Landoni, R. Micciolo, M.V. Davì

Research output: Contribution to journalArticlepeer-review


Introduction: Management of malignant insulinomas is challenging due to the need to control both hypoglycaemic syndrome and tumor growth. Literature data is limited to small series. Aim of the study: To analyze clinico-pathological characteristics, treatments and prognosis of patients with malignant insulinoma. Materials and methods: Multicenter retrospective study on 31 patients (male: 61.3%) diagnosed between 1988 and 2017. Results: The mean age at diagnosis was 48 years. The mean NET diameter was 41±31 mm, and 70.8% of NETs were G2. Metastases were widespread in 38.7%, hepatic in 41.9% and only lymph nodal in 19.4%. In 16.1% of the cases, the hypoglycaemic syndrome occurred after 46±35 months from the diagnosis of originally non-functioning NET, whereas in 83.9% of the cases it led to the diagnosis of NET, of which 42.3% with a mean diagnostic delay of 32.7±39.8 months. Surgical treatment was performed in 67.7% of the cases. The 5-year survival rate was 62%. Overall survival was significantly higher in patients with Ki-67 ≤10% (P =0.03), insulin level
Original languageEnglish
Pages (from-to)439-446
Number of pages8
JournalEur. J. Endocrinol.
Issue number4
Publication statusPublished - 2020


  • corticosteroid
  • diazoxide
  • everolimus
  • insulin
  • Ki 67 antigen
  • pasireotide
  • somatostatin derivative
  • verapamil
  • adult
  • arterial embolization
  • Article
  • cancer chemotherapy
  • cancer patient
  • cancer prognosis
  • cancer radiotherapy
  • cancer staging
  • cancer surgery
  • chemoembolization
  • clinical article
  • clinical feature
  • corticosteroid therapy
  • delayed diagnosis
  • female
  • histopathology
  • human
  • hypoglycemia
  • insulin level
  • insulinoma
  • liver metastasis
  • liver transplantation
  • lymph node metastasis
  • male
  • malignant neoplasm
  • middle aged
  • multimodality cancer therapy
  • overall survival
  • positron emission tomography-computed tomography
  • priority journal
  • radiofrequency ablation
  • radioisotope therapy
  • retrospective study
  • tumor volume
  • clinical trial
  • mortality
  • multicenter study
  • neuroendocrine tumor
  • pancreas tumor
  • pathology
  • prognosis
  • survival rate
  • Female
  • Humans
  • Hypoglycemia
  • Insulinoma
  • Male
  • Middle Aged
  • Neuroendocrine Tumors
  • Pancreatic Neoplasms
  • Prognosis
  • Retrospective Studies
  • Survival Rate

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