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  • Title: Insulinoma after streptozotocin therapy for metastatic gastrinoma: natural history or iatrogenic complication?
    Author: Bar M, Burke M, Isakov A, Almog C.
    Journal: J Clin Gastroenterol; 1990 Oct; 12(5):579-80. PubMed ID: 2172360.
    Abstract:
    Islet cell carcinoma frequently produces more than one chemical product, although its clinical expression is usually restricted to a single hormone. We describe an unusual patient who presented with full-blown metastasizing gastrinoma. He was treated with cimetidine for five years and then streptozotocin therapy, which resulted in a regression in hepatomegaly and a fall in serum gastrin levels. Following one year's therapy with streptozotocin, he was admitted in hyperinsulinemic hypoglycemic stupor. This appears to be the first reported case of a "shift" from clinical gastrinoma to insulinoma possibly related to prolonged streptozotocin therapy.
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