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Chae, Hwang, Ryu, Ko, Rue, Kim, Park, Kim, Cho, Choi, and Lee: A Case of Non-islet Cell Tumor Hypoglycemia
Case Report
Journal of Korean Society of Endocrinology

Journal of Korean Society of Endocrinology 2006; 21(1): 74-78.

Published online: 20 February 2006

DOI: https://doi.org/10.3803/jkes.2006.21.1.74

A Case of Non-islet Cell Tumor Hypoglycemia

Yun-Tae Chae, Il-Jun Hwang, Kyung-Hee Ryu, Eun-Hyang Ko, Jung-Im Rue, Soo-Kyung Kim, Seok-Won Park, Yoo-Ri Kim, Yong-Wook Cho, Young-Kil Choi, Sang-Jong Lee

Department of Internal Medicine, Pochon CHA University College of Medicine, Sungnam, Korea.

Received 11 August 2005       Accepted 27 October 2005

Copyright © 2006 Korean Endocrine Society

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

Keywords: Hypoglycemia, IGF-I, IGF-II, NICTH (Non-islet Cell Tumor Hypoglycemia)

Figures and Tables

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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