Giant neurinoma with the hypoglycemic syndrome

Abstract

Currently, more than 50 causes of hypoglycemia are known. Among its rare varieties is hypoclycemia, due to the presence of a large tumor, complicating the course of various extra-pancreatic neoplasms. The frequency of “tumor” hypoglycemia is not exactly established, but it is much less common with insulin occurring with the same clinical picture.

The mechanism for the development of tumor hypoglycemia remains unknown. It is believed that the tumor intensely absorbs glucose or inhibits gluconeogenesis in the liver. According to another theory, extrapancreatic tumors produce insulin-like growth factors that interact with insulin receptors. Despite the lack of a clear understanding of the pathogenesis of tumor hypoglycemia, timely removal of the tumor leads to normalization of carbohydrate metabolism. We present our observation.