Metastatic insulinoma is a very rare type of neuroendocrine cancer that occurs as a tumor in the pancreas and produces extra insulin (hyperinsulinemia), causing low blood sugar levels (hypoglycemia). Metastatic insulinoma can spread to the lymph nodes and liver.

Symptoms of malignant insulinoma may include weakness; tremor; palpitations; rapid heartbeat; excessive sweating; increased appetite; vision, behavioral, and personality changes; seizures; coma; and death.

Treatment for malignant insulinoma may include wide resection surgery of the pancreas and liver, somatostatin analogues (octreotide) and mTOR inhibitors to control blood glucose levels, chemoembolization, radiofrequency ablation (RFA), and kinase inhibitors (sunitinib malate).