title: The oncological emergency case: paraneoplastic hypoglycemia in metastatic breast cancer - case report and brief review of the literature.
abstract: BACKGROUND
  Paraneoplastic hypoglycemia is a rare syndrome amoung tumorous diseases. It is often associated with a paraneoplastic secretion of 'big' insulin-like growth factor-II.
  
  
  METHODS
  We describe this syndrome in a 60-year-old patient with advanced breast cancer 8 years after primary diagnosis.
  
  
  CONCLUSIONS
  This non-islet cell tumor-induced hypoglycemia may be the only evidence for an otherwise clinically occult disease progression. Fast diagnosis and appropriate acute and causal treatment concepts should be part of oncological management.
authors.affiliation: Breast Center, Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany.
authors.forename: Lisa
authors.initials: L
authors.lastname: Richters
authors.affiliation: Institute of Pathology, University of Cologne, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Ortmann
authors.affiliation: Center for Endocrinology, Diabetes and Preventive Medicine, University Hospital of Cologne, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Faust
authors.affiliation: Breast Center, Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Krämer
authors.affiliation: Breast Center, Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Mallmann
authors.affiliation: Breast Center, Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany ; Breast Center, Department of Obstetrics and Gynecology, University Hospital of Munich, Germany.
authors.forename: Nadia
authors.initials: N
authors.lastname: Harbeck
authors.affiliation: Breast Center, Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Rhiem
keywords: Breast cancer; Hypoglycemia; Insulin-like growth factor; Metastases; Paraneoplastic