title: Severe hypoglycemia and hypokalemia in association with liver metastases of gastric cancer.
abstract: We report an 80-year-old man who presented with non-islet cell tumor hypoglycemia (NICTH) in association with hepatic recurrence of gastric cancer. His serum potassium was reduced from 3.9 to 3.1 mmol/l 5 weeks after gastrectomy, and he subsequently developed hypoglycemic coma. He was diagnosed as having NICTH because of the presence of serum big IGF-II and positive staining for IGF-II in gastric cancer cells obtained at surgery. A computed tomography showed multiple liver metastases. His hypoglycemia was refractory to steroid therapy. This case suggested that NICTH could develop in association with hepatic metastases of gastric cancer. Unexpected hypokalemia may be a manifestation of occult NICTH.
authors.affiliation: Renal, Endocrine and Metabolism Division, Shizuoka Cancer Center Hospital, Nagaizumi-cho.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kato
authors.forename: Etsuro
authors.initials: E
authors.lastname: Bando
authors.forename: Shingo
authors.initials: S
authors.lastname: Shinozaki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yonemura
authors.forename: Motohiko
authors.initials: M
authors.lastname: Aiba
authors.forename: Izumi
authors.initials: I
authors.lastname: Fukuda
authors.forename: Naomi
authors.initials: N
authors.lastname: Hizuka
authors.forename: Toru
authors.initials: T
authors.lastname: Kameya
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000737:chemistry / Q000000981:diagnostic imaging / Q000556:secondary*; D000368:Aged; D000369:Aged, 80 and over; D005743:Gastrectomy; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007008:Hypokalemia / Q000209:etiology*; D007335:Insulin-Like Growth Factor II / Q000032:analysis; D008113:Liver Neoplasms / Q000097:blood / Q000737:chemistry / Q000000981:diagnostic imaging / Q000556:secondary*; D008297:Male; D011498:Protein Precursors / Q000032:analysis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D011498:Protein Precursors; C066038:proinsulin-like growth factor II; D007335:Insulin-Like Growth Factor II