[Unusual coincidence of partially active endocrine tumors]

We report on a female patient who developed five different tumors between the age of 53 and 62 years. The following tumors were diagnosed, three of which showed endocrine activity: uterine myoma; hemangiopericytoma of the meninges; pleural mesothelioma; preperitoneal leiomyoma; medullary carcinoma of the thyroid (sporadic form) in a hyperthyroid goiter. Coexistence of hyperthyroidism and medullary carcinoma of the thyroid is rare. Paraneoplastically induced hypoglycemia--in this patient induced by the pleural mesothelioma and less by the preperitoneal leiomyoma--is of similarly infrequent occurrence. Tumors of epithelial or mesenchymal origin may cause hypoglycemia as a result of peptide secretion, exerting an insulin-like effect. The detection of IGF-I and IGF-II in the serum confirms the diagnosis. Insulinoma can be differentiated by the absence of hyperinsulinemia.