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High molecular weight form insulin-like growth factor II-producing mesenteric sarcoma causing hypoglycemia
Ryuji Sato1, Motoyoshi Tsujino, Kenji Nishida
1Division of Internal Medicine and Surgery, Tokyo Metropolitan Fuchu Hospital, Tokyo.
Internal Medicine (Tokyo, Japan)
|December 4, 2004
Summary
A rare mesenteric sarcoma producing high molecular weight insulin-like growth factor II (IGF-II) caused recurrent hypoglycemia in an 81-year-old woman. Surgical resection of the tumor resolved hypoglycemia and normalized IGF-II levels.
Area of Science:
- Endocrinology
- Oncology
- Gastroenterology
Background:
- Hypoglycemia can be caused by various factors, including insulinomas and extrapancreatic tumors.
- Insulin-like growth factor II (IGF-II) is implicated in tumor-induced hypoglycemia, but its exact role and mechanisms remain under investigation.
Observation:
- An 81-year-old female patient experienced recurrent episodes of hypoglycemia with normal insulin levels but elevated serum IGF-II.
- A spindle cell sarcoma of the sigmoid colon mesentery was identified as the source of IGF-II production.
- Tumor resection led to the resolution of hypoglycemia and a decrease in serum IGF-II levels.
Findings:
- Immunohistochemistry and RT-PCR confirmed IGF-II expression in tumor cells.
- Immunoblotting detected high molecular weight (HMW) IGF-II in the patient's serum.
- This case represents the first documented instance of HMW IGF-II-producing mesenteric sarcoma causing hypoglycemia.
Implications:
- This study highlights the importance of considering rare tumors in the differential diagnosis of unexplained hypoglycemia.
- The findings underscore the role of aberrant IGF-II production, particularly HMW forms, in oncogenic hypoglycemia.
- Further research into HMW IGF-II may offer new diagnostic and therapeutic strategies for related conditions.