title: Hepatoma with severe non-islet cell tumor hypoglycemia.
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.
authors.affiliation: Department of Gastroenterology and Hepatology, Medizinische Hochschule Hannover, Germany.
authors.forename: U J
authors.initials: UJ
authors.lastname: Tietge
authors.forename: C
authors.initials: C
authors.lastname: Schöfl
authors.forename: K W
authors.initials: KW
authors.lastname: Ocran
authors.forename: S
authors.initials: S
authors.lastname: Wagner
authors.forename: K H
authors.initials: KH
authors.lastname: Böker
authors.forename: G
authors.initials: G
authors.lastname: Brabant
authors.forename: J
authors.initials: J
authors.lastname: Zapf
authors.forename: M P
authors.initials: MP
authors.lastname: Manns
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000150:complications*; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007335:Insulin-Like Growth Factor II / Q000378:metabolism; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D010257:Paraneoplastic Syndromes / Q000503:physiopathology*
chemical_list: D007335:Insulin-Like Growth Factor II