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Secretion of a large molecular-weight form of insulin-like growth factor by a primary renal tumor

E Korn1, J Van Hoff, P Buckley

  • 1Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520-8064, USA.

Medical and Pediatric Oncology
|June 1, 1995
PubMed

Insights

A pediatric renal tumor caused hypoglycemia by secreting abnormal insulin-like growth factor II (IGF-II). Tumor removal resolved the hypoglycemia, with normalized IGF-II levels. This highlights a rare tumor-related metabolic complication.

Area of Science:

  • Pediatric Oncology
  • Endocrinology
  • Biochemistry

Background:

  • Non-islet cell tumor-related hypoglycemia is a rare paraneoplastic syndrome.
  • Insulin-like growth factor II (IGF-II) has been implicated in some cases of tumor-induced hypoglycemia.
  • Pediatric renal tumors are diverse, with varying associated complications.

Observation:

  • A 5-year-old boy presented with an abdominal mass and recurrent biochemical hypoglycemia.
  • Hypoglycemia resolved post-operatively after resection of the primary renal tumor.
  • Tumor tissue and preoperative serum showed elevated levels of IGF-II and its precursor, pro-IGF-II.

Findings:

  • The pediatric renal tumor contained significantly elevated levels of IGF-II.
  • A large-molecular weight precursor form of IGF-II (pro-IGF-II) constituted a substantial portion of total IGF-II in the tumor and preoperative serum.
  • Pro-IGF-II was undetectable in serum 6 weeks after tumor resection.

Implications:

  • This case suggests that abnormal IGF-II secretion by a pediatric renal tumor can cause hypoglycemia.
  • The findings establish a novel association between a specific pediatric renal tumor, non-islet cell tumor-related hypoglycemia, and elevated tumor IGF-II.
  • This case expands the understanding of paraneoplastic syndromes in pediatric oncology and the metabolic effects of specific tumor products.

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