Non-Islet Cell Tumor Hypoglycemia Is Caused by Big IGF-II in a Patient with a Carcinosarcoma of the Uterus

Intern Med. 2015;54(24):3165-9. doi: 10.2169/internalmedicine.54.4945. Epub 2015 Dec 15.

Abstract

We report a 72-year-old Japanese woman with severe hypoglycemia. The laboratory data, which revealed the suppression of serum insulin, suggested the existence of non-islet cell tumor hypoglycemia (NICTH). Abdominal computed tomography demonstrated the presence of a huge uterine tumor. The patient was treated with a continuous infusion of glucose, but died of sepsis on day 46. An autopsy revealed the pathological diagnosis to be a carcinosarcoma of the uterus. Interestingly, an immunohistochemical study discovered the expression of insulin-like growth factor (IGF)-II in both the carcinoma and sarcoma cells. In addition, an immunoblot analysis of blood samples revealed the presence of circulating big IGF-II. Therefore, this is a novel case of NICTH that was caused by a uterine carcinosarcoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinosarcoma / diagnosis
  • Carcinosarcoma / physiopathology*
  • Diagnosis, Differential
  • Female
  • Humans
  • Hypoglycemia / etiology*
  • Insulin-Like Growth Factor II / biosynthesis*
  • Tomography, X-Ray Computed / adverse effects
  • Uterine Neoplasms / diagnosis
  • Uterine Neoplasms / physiopathology*

Substances

  • IGF2 protein, human
  • Insulin-Like Growth Factor II