Mithramycin for Hypoglycemia in Malignant Insulinoma

Abstract

HYPOGLYCEMIA occurs in 90 per cent of patients with functioning islet-cell tumors and is difficult to manage.1 Although diazoxide and streptozotocin are useful agents for treatment,2 they are not uniformly successful. We report here the initially successful use of mithramycin, an inhibitor of RNA synthesis,3 in a patient with intractable hypoglycemia due to metastatic islet-cell carcinoma. Materials and Methods A 59-year-old woman had symptomatic hypoglycemia with a low plasma glucose (29 mg per 100 ml) and a concomitant increased serum insulin (114 μU per milliliter). Exploratory laparotomy revealed a large tumor in the pancreas and multiple hepatic nodules that on . . .