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Acinar cell carcinoma of the pancreas associated with hypoglycemia: involvement of "big" insulin-like growth factor-II.
Mizuta, Y; Isomoto, H; Futuki, Y; Ehara, N; Takeshima, F; Omagari, K; Murase, K; Yakata, Y; Senjyu, M; Masuda, J; Ikuno, N; Haraguchi, M; Iwasaki, K; Shimokawa, I; Kohno, S.
Afiliação
  • Mizuta Y; The Second Department of Internal Medicine, Nagasaki University School of Medicine, Sakamoto, Japan.
J Gastroenterol ; 33(5): 761-5, 1998 Oct.
Article em En | MEDLINE | ID: mdl-9773947
Apart from insulinomas, pancreatic tumors are rarely complicated by hypoglycemia and some may produce insulin-like growth factor II (IGF-II). To our knowledge, IGF-II-producing pancreatic tumors associated with hypoglycemia have not been reported previously. We describe what we believe to be the first case of "big" IGF-II-producing pancreatic acinar cell carcinoma. A 68-year-old man presented with a history of recurrent hypoglycemia. Abdominal computed tomography scan and magnetic resonance imaging showed a mass, approximately 5 cm in diameter, in the tail of the pancreas and two low-density areas in the liver. Low serum glucose was associated with low insulin levels and high levels of hormones (i.e., glucagon and IGF-II) that are functionally opposite to insulin. Although serum IGF-II level was within the normal range, most IGF-II was of the high molecular weight form, as determined by Western immunoblot analysis. Based on these findings, a diagnosis of hypoglycemia induced by IGF-II-producing pancreatic tumor was made. Surgery was not possible because of the patient's poor general condition. The patient ultimately died as a result of malignant cachexia. At autopsy, a yellowish-white tumor was found in the tail of the pancreas, and a histopathologic diagnosis of acinar cell carcinoma was made. Immunohistologically, the tumor cells contained IGF-II in an irregular staining pattern, suggesting that the hypoglycemia was caused by a pancreatic tumor producing "big" IGF-II.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Fator de Crescimento Insulin-Like II / Carcinoma de Células Acinares / Hipoglicemia Tipo de estudo: Diagnostic_studies / Risk_factors_studies Limite: Aged / Humans / Male Idioma: En Revista: J Gastroenterol Ano de publicação: 1998 Tipo de documento: Article
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Fator de Crescimento Insulin-Like II / Carcinoma de Células Acinares / Hipoglicemia Tipo de estudo: Diagnostic_studies / Risk_factors_studies Limite: Aged / Humans / Male Idioma: En Revista: J Gastroenterol Ano de publicação: 1998 Tipo de documento: Article