Case Report
American Journal of Gastroenterology (1998) 93, 997–1000; doi:10.1111/j.1572-0241.1998.00297.x
Hepatoma with severe non-islet cell tumor hypoglycemia
Uwe J F Tietge MD1, Christof Schöfl MD2, Kenneth W Ocran MD2, Siegfried Wagner MD1, Klaus H.W. Böker MD1, Georg Brabant MD2, Jürgen Zapf MD3 and Michael P Manns MD1
- 1Department of Gastroenterology and Hepatology, Medizinische Hochschule Hannover, Hannover, Germany
- 2Department of Clinical Endocrinology, Medizinische Hochschule Hannover, Hannover, Germany
- 3Metabolic Unit, Department of Medicine, University Hospital, Zürich, Switzerland
Correspondence: Prof Dr Michael P Manns, MD, Dept. of Gastroenterology and Hepatology, OE 6810, Medizinische Hochschule Hannover, D-30623 Hannover, Germany
Received 21 August 1997; Revised 0000; Accepted 6 March 1998.
Abstract
We report a 22-yr-old male patient with chronic hepatitis B and a large, well differentiated hepatoma who developed episodes of symptomatic fasting hypoglycemia, which were caused by paraneoplastic secretion of unprocessed "big" insulin-like growth factor-II. Initially, the patient presented with normal liver function, which deteriorated during the clinical course. Therapeutic attempts to reduce tumor mass failed and the patient subsequently died because of metastases of the hepatoma. The pathophysiology of non-islet cell tumor hypoglycemia, differential diagnosis, and therapeutic options are discussed.
