Hypoglycemia-Producing Extrapancreatic Neoplasms

Abstract

Forty-eight huge extrapancreatic neoplasms, which were associated with attacks of spontaneous hypoglycemia, were reviewed from the literature. These attacks ceased when operable tumors were removed, and recurred when the tumors recurred or developed sizable metastases. The majority of the tumors were malignant. Twenty-five tumors were classified as mesodermal and were located in or around the mediastinum or peritoneum. Twenty-three tumors were of epithelial carcinomatous structure, presenting as primary hepatomas (16), adrenal carcinomas (5), and peritoneal pseudomyxomas (2). None of the tumors had any apparent relation to the pancreas, either in location or in structure. All of them were very large. Production of an insulin-like substance by the tumor and abnormal glycogen storage within the tumor, with diversion from other areas, were regarded as being the most likely explanations of the hypoglycemia.