[Recurrent @entity4053 caused by XXXX as a therapeutic option].

@entity1 @entity632 @entity558 @entity8 @entity5 @entity6335 @entity2690 @entity1163 @entity3839 @entity4053 @entity4831 @entity3 @entity413 @entity9468 @entity3270 @entity1487
HISTORY AND CLINICAL FINDINGS: A 73-year-old previously healthy @entity1 presented with recurrent weakness, @entity9468 and perioral paresthesia of 3 months' duration. Physical examination on admission was unremarkable and revealed a @entity1 in @entity558 . INVESTIGATIONS: Recurrent episodes of @entity4053 let us to proceed with a fasting test. The test was stopped after 24 hours when the @entity1 became @entity1163 and was found to have a blood sugar value of 2.2 mmol/l (accompanied by inadequately increased values for @entity2690 , insulin and C-peptide). Ultrasound and computertomography of the abdomen showed a huge inhomogeneous mass in the tail of @entity8 in the liver, respectively. Core needle biopsies revealed typical histopathological findings of a @entity3270 . TREATMENT AND COURSE: Eight cycles of chemotherapy were given using @entity3839 / @entity632 for three cycles and @entity3839 / @entity1487 for the remaining therapy over a period of 16 months resulting in a reduction in size of liver @entity3 and improvement of symptoms. Following 6 months without any therapy new episodes of severe @entity4053 and progression of the liver @entity3 occurred. Despite seven further cycles of chemotherapy and additional treatment with @entity6335 /octreotide the @entity1 remained hypoglycemic and continuous @entity413 infusions became necessary. Therefore, chemoembolization of the liver with @entity3839 / @entity1487 and @entity4831 -emulsion was performed. This resulted in a significant improvement of symptoms and the @entity1 could subsequently be discharged. The @entity1 died 4 months later. CONCLUSION: Chemoembolization is an effective possibility in the palliative treatment of advanced @entity5 .
