J Korean Soc Endocrinol.  2006 Feb;21(1):74-78. 10.3803/jkes.2006.21.1.74.

A Case of Non-islet Cell Tumor Hypoglycemia

• Chae YT
• Hwang IJ
• Ryu KH
• Ko EH
• Rue JI
• Kim SK
• Park SW
• Kim YR
• Cho YW
• Choi YK
• Lee SJ

• KMID: 2200670
• DOI: http://doi.org/10.3803/jkes.2006.21.1.74

Abstract

Mesenchymal tumors including hemangiopericytomas, hepatocellular tumors, adrenal carcinomas, and a variety of other large tumors have been reported to produce excessive amounts of insulin-like growth factor (IGF) type II precursor, which binds weakly to insulin receptors and strongly to IGF-I receptors, leading to insulin like actions. In addition to increased IGF-II production, IGF-II bioavailability is increased due to complex alterations in circulating binding proteins. The authors of this article diagnosed non-islet cell tumor hypoglycemia from an 81-year-old male patient suffering from repetitive fasting hypoglycemia while he has not received any treatment for pulmonary hemangiopericytoma diagnosed in the past. Moreover, this topic is getting reported as the authors have experienced a significant improvement of catamnesis by a treatment with glucocorticoid.

MeSH Terms

Aged, 80 and over
Biological Availability
Carrier Proteins
Hemangiopericytoma
Humans
Hypoglycemia*
Insulin
Insulin-Like Growth Factor I
Insulin-Like Growth Factor II
Male
Receptor, IGF Type 1
Receptor, Insulin
Carrier Proteins
Insulin
Insulin-Like Growth Factor I
Insulin-Like Growth Factor II
Receptor, IGF Type 1
Receptor, Insulin

Figure

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  Fig. 1 Chest PA shows a huge mass lesion at the left lower lung.

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  Fig. 2 Chest CT shows a 8 cm sized huge mass lesion at the left lower lung in the arterial phase (A). Follow up CT after 11 months shows a slightly increased (11.3 cm sized) huge mass lesion at the left lower lung in the arterial phase (B).

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  Fig. 3 Histologic examination of tumor tissue. (A) Tumor cells are composed of mainly spindle cells and show highly mitotic figure (arrow) (H & E stain, × 200). (B) In immunohistochemical stain, CD 34 positive cells are shown (× 300).

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  Fig. 4 Peripheral blood glucose levels before and after administration of prednisolone. (Large and small arrows indicate meals and snacks, respectively.)

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