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Published on: January 22, 2013
A Paradigm Shift in Renal Cell Carcinoma: Recognizing Hypoglycaemia as a Significant Paraneoplastic Syndrome
Madhumitha S1, Deepankumar T1, Krishnaswamy Madhavan1
1Department of General Medicine, Sri Ramaswamy Memorial (SRM) Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Chengalpattu, IND.
Abstract:
Recurrent hypoglycaemia is a rare paraneoplastic syndrome associated with several cancers, including renal cell carcinoma (RCC). Here we present a curious case of a patient with type 2 diabetes mellitus (T2DM) who had numerous hospitalisations due to recurrent hypoglycaemia. A well-defined lesion at the lower pole of the right kidney and bilateral pyelonephritis were found during imaging investigations. A biopsy from the lesion confirmed clear cell carcinoma of the kidney and the most probable cause of recurrent hypoglycemia was paraneoplastic syndrome related to RCC. Analysis of Insulin-like growth factor levels revealed that recurrent hypoglycaemia might be the result of non-islet cell tumor-hypoglycaemia (NICTH). This case emphasizes how crucial it is to rule out paraneoplastic syndromes like NICTH in individuals presenting with hypoglycaemia that cannot be explained, even when pre-existing diabetes is present. Furthermore, this study emphasizes the need to include RCC in the differential diagnosis.
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