Hypoglycemia attributable to insulin-like growth factor-II prohormone-producing metastatic leiomyosarcoma.
| Autor: | Baig M; Department of Medicine, Physiology, and Biophysics, University of South Florida for Health Sciences, and J. A. Haley Veterans Hospital, Tampa, Florida, USA., Hintz RL, Baker BK, Vesely DL |
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| Jazyk: | angličtina |
| Zdroj: | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists [Endocr Pract] 1999 Jan-Feb; Vol. 5 (1), pp. 37-42. |
| DOI: | 10.4158/EP.5.1.37 |
| Abstrakt: | Objective: To review the causes of nonpancreatic tumor-associated hypoglycemia and report the first case of hypoglycemia attributable to a leiomyosarcoma, which did not cause hypoglycemia in its primary site but only after metastasizing. Methods: A case report is presented of a 62-year-old man with a gastric leiomyosarcoma diagnosed and surgically treated 8 years previously, who was found to have 14 large, rounded masses in his liver and a blood glucose level of 19 mg/dL. Biopsy of the largest mass revealed a leiomyosarcoma. Results: Evaluation of the cause of the hypoglycemia revealed that circulating insulin, connecting peptide, proinsulin, insulin-like growth factor-I (somatomedin C), and insulin-like growth factor-II levels were below normal, whereas the insulin-like growth factor-II prohormone concentration was increased twofold. Basal and corticotropin-stimulated serum cortisol values were normal. Conclusion: This is the first case report of hypoglycemia occurring only after metastasis of a leiomyosarcoma. A possible causal relationship between the hypoglycemia and the increased circulating insulin-like growth factor-II prohormone is suggested, and alternative explanations and treatment are discussed. |
| Databáze: | MEDLINE |
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