Persistent hypoglycemia in the setting of metastatic malignant insulinoma to the liver treated with chemoembolization and bland embolization

We are describing a patient with malignant insulinoma and unusual clinical pathological features. The presented late in the course of disease history abdominal pain was found to have large tumor pancreas metastasis liver. Also, he acute diarrhea which is not feature Insulinoma. During hospital stay had sever hypoglycemia very inappropriately high low blood glucose levels Insulin, C- peptide Proinsulin. On biopsy it be neuroendocrine tumor, but staining’s for Insulin were negative. treated surgical resection distal when located, splenectomy, cholecystectomy appendectomy. chemoembolization embolization metastatic tumors liver done patient’s Diazoxide short Steroids Octreotide. underscore need combined clinical, laboratory, radiological approach while diagnosing