LONG-TERM EFFECT OF ¹⁷⁷LU-DOTATATE ON SEVERE AND REFRACTORY HYPOGLYCEMIA ASSOCIATED WITH MALIGNANT INSULINOMA

Objective: Malignant insulinoma is an extremely uncommon tumor that is usually accompanied by severe hypoglycemia that is difficult to manage. At this time, the long-term effect of ¹⁷⁷Lu-DOTATATE (lutetium [Lu-177]-DOTA-Tyr3-octreotate) on this tumor is not well known.

Methods: We report a case of severe, life-threatening, and refractory hypoglycemia associated with malignant insulinoma treated with ¹⁷⁷Lu-DOTATATE.

Results: A 51-year-old woman was referred because of severe, life-threatening, and refractory hypoglycemia due to malignant insulinoma. The patient had been treated unsuccessfully with chemotherapy, targeted therapies, and symptomatic therapy with diazoxide, steroids, and somatostatin analogues without success. ¹⁷⁷Lu-DOTATATE adequately controlled her hypoglycemia after the other conventional treatments failed.

Conclusion: ¹⁷⁷Lu-DOTATATE was effective in providing rapid and long-term symptomatic control of the hypoglycemia and significantly improved the quality of life of the patient.