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Spontaneous Hypoglycemia Associated with Massive Hepatoma: A Review of Current Concepts and Report of a Case

Spontaneous Hypoglycemia Associated with Massive Hepatoma: A Review of Current Concepts and... Abstract The first report of primary carcinoma of the liver associated with hypoglycemia was a case described by Nadler and Wolfer, in 1929.1 The authors considered that the hypoglycemia could have resulted at least in part from a quantitative loss of liver substance, but they were disturbed by the absence of symptoms suggestive of hepatic insufficiency. Relatively little has been added to clarify this problem since the initial publication. This can be partially explained by the paucity of reports of hypoglycemia associated with hepatoma. Although primary carcinoma of the liver is an uncommon tumor in this country, it is, nevertheless, estimated to occur in 0.47% of autopsied cases.2 However, there have been only five reports relating this tumor to hypoglycemia.1,3-6 It is of interest that no mention is made of hepatoma as a cause of hypoglycemia in the extensive review of the causes of hypoglycemia by Conn* and References 1. Our insert. 2. Nadler, W. H., and Wolfer, J. A.: Hepatogenic Hypoglycemia Associated with Primary Liver Cell Carcinoma , Arch. Int. Med. 44:700, 1929.Crossref 3. MacDonald, R. A.: Primary Carcinoma of the Liver , A. M. A. Arch. Int. Med. 99:266, 1957.Crossref 4. Crawford, W.: Hypoglycemia with Coma in a Case of Primary Carcinoma of the Liver , Am. J. M. Sc. 181:496, 1931.Crossref 5. Beers, D. N., and Morton, J. J.: Primary Carcinoma of the Liver with Hypoglycemia , Am. J. Cancer 24:51, 1935.Crossref 6. Thompson, C. M., and Hilferty, D. J.: Primary Carcinoma of the Liver (Cholangioma) with Hypoglycemic Convulsions , Gastroenterology 20: 158, 1952. 7. McFadzean, A. J., and Yeung, T. T.: Hypoglycemia in Primary Carcinoma of the Liver , A. M. A. Arch. Int. Med. 98:720, 1956.Crossref 8. Conn, J., and Seltzer, H.: Spontaneous Hypoglycemia , Am. J. Med. 19:460, 1955.Crossref 9. Hines, R. E.: Hypoglycemia Apparently Due to Retroperitoneal Sarcoma , M. Bull. Vet. Admin. 20:102, 1943. 10. Arkless, H. A.: Coincidence of Rhabdomyofibroma of Diaphragm, Idiopathic Hypoglycemia and Retroperitoneal Sarcoma , M. Bull. Vet. Admin. 19:225, 1942. 11. Scholz, D.; Woolner L., and Priestley J.: Spontaneous Hypoglycemia Associated with Fibrogenic Tumor: Report of 2 Cases , Ann. Int. Med. 46:796, 1957.Crossref 12. August, J., and Hiatt, H.: Severe Hypoglycemia Secondary to a Nonpancreatic Fibrosarcoma with Insulin Activity , New England J. Med. 258:17, 1958.Crossref 13. Porter, M., and Frantz, V.: Tumors Associated with Hypoglycemia: Pancreatic and Extrapancreatic , Am. J. Med. 21:944, 1956.Crossref 14. Silvis, R. S., and Simon, D. S.: Marked Hypoglycemia Associated with Nonpancreatic Tumors , New England J. Med. 254:14, 1956.Crossref 15. Skillern, P.; McCormack, L.; Hewlett, J., and Crile, G.: Hyperinsulinism Due to Islet-Cell Tumors Simulating Sarcoma , Diabetes 3:133, 1954. 16. Rosenfield, E. D.: Peritoneal Pseudomyxoma: A Report of 4 Unusual Cases , Arch. Path. 48:255, 1949. 17. Mellinkoff, S., and Tumulty, P.: Hepatic Hypoglycemia , New England J. Med. 247:745, 1952.Crossref 18. Evans, C. L.; Tsai, C., and Young, F. G.: The Behavior of Liver Glycogen in Experimental Animals: I. Methods; The Effect of Ether and Amytal , J. Physiol. 73:67, 1931. 19. Vallance-Owen, J.; Hurlock, B., and Please, N.: Plasma-Insulin Activity in Diabetes Mellitus Measured by the Rat Diaphragm Technique , Lance 2:583, 1955.Crossref 20. Forsham, P. H., and Thorn, G. W.: Changes in Inorganic Serum Phosphorous During the Intravenous Glucose Tolerance Test as an Adjunct to the Diagnosis of Early Diabetes Mellitus , Proc. Am. Diabetes A. 9:101, 1949. 21. Soskin, S.; Levine, R., and Hechter, O.: Relation Between Phosphate Changes in Blood and Muscle Following Dextrose, Insulin and Epinephrine Administration , Am. J. Physiol. 134:40, 1941. 22. Pollack, H.; Millet, R. F.; Essex, H. E.; Mann, F. C., and Bollman, D. L.: Serum Phosphate Changes Induced by Injection of Glucose into Dogs Under Various Conditions , Am. Physiol. 110:117, 1934. 23. Weber, G., and Cantero, A.: Glucose-6-Phosphatase Activity in Normal, Precancerous, and Neoplastic Tissues , Cancer Res. 15:105, 1955. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

Spontaneous Hypoglycemia Associated with Massive Hepatoma: A Review of Current Concepts and Report of a Case

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Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0888-2479
DOI
10.1001/archinte.1959.00270020101011
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Abstract

Abstract The first report of primary carcinoma of the liver associated with hypoglycemia was a case described by Nadler and Wolfer, in 1929.1 The authors considered that the hypoglycemia could have resulted at least in part from a quantitative loss of liver substance, but they were disturbed by the absence of symptoms suggestive of hepatic insufficiency. Relatively little has been added to clarify this problem since the initial publication. This can be partially explained by the paucity of reports of hypoglycemia associated with hepatoma. Although primary carcinoma of the liver is an uncommon tumor in this country, it is, nevertheless, estimated to occur in 0.47% of autopsied cases.2 However, there have been only five reports relating this tumor to hypoglycemia.1,3-6 It is of interest that no mention is made of hepatoma as a cause of hypoglycemia in the extensive review of the causes of hypoglycemia by Conn* and References 1. Our insert. 2. Nadler, W. H., and Wolfer, J. A.: Hepatogenic Hypoglycemia Associated with Primary Liver Cell Carcinoma , Arch. Int. Med. 44:700, 1929.Crossref 3. MacDonald, R. A.: Primary Carcinoma of the Liver , A. M. A. Arch. Int. Med. 99:266, 1957.Crossref 4. Crawford, W.: Hypoglycemia with Coma in a Case of Primary Carcinoma of the Liver , Am. J. M. Sc. 181:496, 1931.Crossref 5. Beers, D. N., and Morton, J. J.: Primary Carcinoma of the Liver with Hypoglycemia , Am. J. Cancer 24:51, 1935.Crossref 6. Thompson, C. M., and Hilferty, D. J.: Primary Carcinoma of the Liver (Cholangioma) with Hypoglycemic Convulsions , Gastroenterology 20: 158, 1952. 7. McFadzean, A. J., and Yeung, T. T.: Hypoglycemia in Primary Carcinoma of the Liver , A. M. A. Arch. Int. Med. 98:720, 1956.Crossref 8. Conn, J., and Seltzer, H.: Spontaneous Hypoglycemia , Am. J. Med. 19:460, 1955.Crossref 9. Hines, R. E.: Hypoglycemia Apparently Due to Retroperitoneal Sarcoma , M. Bull. Vet. Admin. 20:102, 1943. 10. Arkless, H. A.: Coincidence of Rhabdomyofibroma of Diaphragm, Idiopathic Hypoglycemia and Retroperitoneal Sarcoma , M. Bull. Vet. Admin. 19:225, 1942. 11. Scholz, D.; Woolner L., and Priestley J.: Spontaneous Hypoglycemia Associated with Fibrogenic Tumor: Report of 2 Cases , Ann. Int. Med. 46:796, 1957.Crossref 12. August, J., and Hiatt, H.: Severe Hypoglycemia Secondary to a Nonpancreatic Fibrosarcoma with Insulin Activity , New England J. Med. 258:17, 1958.Crossref 13. Porter, M., and Frantz, V.: Tumors Associated with Hypoglycemia: Pancreatic and Extrapancreatic , Am. J. Med. 21:944, 1956.Crossref 14. Silvis, R. S., and Simon, D. S.: Marked Hypoglycemia Associated with Nonpancreatic Tumors , New England J. Med. 254:14, 1956.Crossref 15. Skillern, P.; McCormack, L.; Hewlett, J., and Crile, G.: Hyperinsulinism Due to Islet-Cell Tumors Simulating Sarcoma , Diabetes 3:133, 1954. 16. Rosenfield, E. D.: Peritoneal Pseudomyxoma: A Report of 4 Unusual Cases , Arch. Path. 48:255, 1949. 17. Mellinkoff, S., and Tumulty, P.: Hepatic Hypoglycemia , New England J. Med. 247:745, 1952.Crossref 18. Evans, C. L.; Tsai, C., and Young, F. G.: The Behavior of Liver Glycogen in Experimental Animals: I. Methods; The Effect of Ether and Amytal , J. Physiol. 73:67, 1931. 19. Vallance-Owen, J.; Hurlock, B., and Please, N.: Plasma-Insulin Activity in Diabetes Mellitus Measured by the Rat Diaphragm Technique , Lance 2:583, 1955.Crossref 20. Forsham, P. H., and Thorn, G. W.: Changes in Inorganic Serum Phosphorous During the Intravenous Glucose Tolerance Test as an Adjunct to the Diagnosis of Early Diabetes Mellitus , Proc. Am. Diabetes A. 9:101, 1949. 21. Soskin, S.; Levine, R., and Hechter, O.: Relation Between Phosphate Changes in Blood and Muscle Following Dextrose, Insulin and Epinephrine Administration , Am. J. Physiol. 134:40, 1941. 22. Pollack, H.; Millet, R. F.; Essex, H. E.; Mann, F. C., and Bollman, D. L.: Serum Phosphate Changes Induced by Injection of Glucose into Dogs Under Various Conditions , Am. Physiol. 110:117, 1934. 23. Weber, G., and Cantero, A.: Glucose-6-Phosphatase Activity in Normal, Precancerous, and Neoplastic Tissues , Cancer Res. 15:105, 1955.

Journal

A.M.A. Archives of Internal Medicine – American Medical Association

Published: Feb 1, 1959

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