Fatal hypoglycemia in malignant pheochromocytoma: direct glucose consumption as suggested by 18F-2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography imaging.

Autor: Mouhammed Habra, Rodolfo Núñez, Hubert Chuang, Montserrat Ayala-Ramirez, Thereasa Rich, Karen Kyle, Camilo Jimenez
Zdroj: Endocrine (1355008X); Feb2010, Vol. 37 Issue 1, p209-212, 4p
Abstrakt: Abstract  We present a patient with metastatic pheochromocytoma, who developed progressive and fatal hypoglycemia most likely secondary to direct tumor glucose consumption that did not respond to high-dose glucose infusion, corticosteroids, or glucagon therapy. The pattern of glucose uptake on 18F-2-fluoro-2-deoxy-d-glucose positron emission tomography, with preferential tumor glucose uptake in association with a marked reduction in normal uptake in the heart, muscles, and brain, is highly suggestive of direct consumption of glucose by the tumor rather than insulin-like growth factor-2 mediated hypoglycemia. In patients with large-volume metastatic malignancies, direct tumor glucose consumption should be considered in the differential diagnosis of hypoglycemia. Nuclear medicine imaging techniques can illustrate the pathophysiology of hypoglycemia in such cases. [ABSTRACT FROM AUTHOR]
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