Hypoglycemia caused by co-secretion of insulin from lung tumor and cardia cancer

first case report

Resumo

CONTEXT: Non-islet-cell-tumor-induced hypoglycemia (NICTH) is caused on rare occasions by secretion of insulin from tumor cells that are reported to have a single tissue origin. CASE REPORT: A 67-year-old male patient had cardia adenocarcinoma and concomitant lung adeno-carcinoma with extensive metastases and repeated episodes of intractable hypoglycemia. Immunohis-tochemical staining for insulin showed that lung adenocarcinoma stained positive and gastric cardia ad-enocarcinoma stained weakly positive. These results indicate that tumor cells of different tissue origins co-secreted insulin. CONCLUSIONS: This is the first report on intractable hypoglycemia due to co-secretion of insulin from two kinds of primary tumor cells in a single patient.