Tumours producing hypoglycaemia

High Molecular Weight Form Insulin-like Growth Factor II-producing Mesenteric Sarcoma Causing Hypoglycemia

“…Currently, most cases with NICTH are attributed to excessive production of IGF-II by the tumors based on the recent accumulating evidence that these tumors produce and secrete IGF-II (1)(2)(3)(4)(5)(6)(7)(8). The diagnosis of the present patient with NICTH was consistent with that of HMW form IGF-IIproducing tumor causing hypoglycemia for the following reasons: 1) preoperative high IGF-II levels; 2) hypoglycemia improved and serum IGF-II levels decreased to normal after tumor resection; 3) the presence of circulating HMW form IGF-II in patient's serum by Western blotting; 4) the expression of IGF-II mRNA and protein by the tumor as demonstrated by real-time quantitative RT-PCR and immunohistochemistry, respectively.…”

“…The present patient had elevated serum levels of IGF-II consisting predominantly of HMW (approximately 19.8 kDa) form. The HMW form IGF-II has been shown to mimic insulin's effects more effectively than a mature (7.5 kDa) form (1,2,(4)(5)(6)(7)(8). In normal subjects, about two-thirds of the circulating mature form IGF-II is present as a ternary 150 kD complex with IGF binding protein-3 (IGFBP-3) and acid-labile subunit (ALS).…”

“…The non-islet cell tumor hypoglycemia (NICTH) syndrome is usually associated with the presence of slowgrowing massive tumors of mesenchymal origin including sarcomas, fibromas, mesotheliomas, histiocytomas, hemangiopericytomas, as well as carcinomas of the liver, stomach, kidney and adrenal (1,2). The hypoglycemia induced by these tumors can be reversed by tumor resection, but it relapses with recurrence of the tumor.…”

“…The hypoglycemia induced by these tumors can be reversed by tumor resection, but it relapses with recurrence of the tumor. Most of the non-islet cell tumors causing such hypoglycemic symptoms have been found to produce and secrete insulin-like growth factor-II (IGF-II) (1)(2)(3)(4)(5)(6)(7)(8).…”

The biochemical investigation of cases of hypoglycaemia: an assessment of the clinical effectiveness of analytical services

“…Pathological disorders involving endogenous hyperinsulinism are usually attributed to abnormal insulin secreting cells, Table 1 Mean serum glucose, insulin, and C peptide values in the patient groups according to diagnosis whether benign, malignant 8 or, rarely, ectopic. 9 Owing largely to the difficulty and unreliability of preoperative tumour localisation, 10 many of these cases were not concluded during the survey.…”