Severe Hypoglycemia and Hypokalemia in Association with Liver Metastases of Gastric Cancer

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  • KATO Akihiko
    Renal, Endocrine and Metabolism Division, Shizuoka Cancer Center Hospital
  • BANDO Etsuro
    Gastric Surgery Division, Shizuoka Cancer Center Hospital
  • SHINOZAKI Shingo
    Renal, Endocrine and Metabolism Division, Shizuoka Cancer Center Hospital
  • YONEMURA Yutaka
    Gastric Surgery Division, Shizuoka Cancer Center Hospital
  • AIBA Motohiko
    Department of Pathology, Tokyo Women's Medical University Daini Hospital
  • FUKUDA Izumi
    Department of Medicine II, Tokyo Women's Medical University
  • HIZUKA Naomi
    Department of Medicine II, Tokyo Women's Medical University
  • KAMEYA Toru
    Pathology Division, Shizuoka Cancer Center Hospital

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Abstract

We report an 80-year-old man who presented with non-islet cell tumor hypoglycemia (NICTH) in association with hepatic recurrence of gastric cancer. His serum potassium was reduced from 3.9 to 3.1 mmol/l 5 weeks after gastrectomy, and he subsequently developed hypoglycemic coma. He was diagnosed as having NICTH because of the presence of serum big IGF-II and positive staining for IGF-II in gastric cancer cells obtained at surgery. A computed tomography showed multiple liver metastases. His hypoglycemia was refractory to steroid therapy. This case suggested that NICTH could develop in association with hepatic metastases of gastric cancer. Unexpected hypokalemia may be a manifestation of occult NICTH.

Journal

  • Internal Medicine

    Internal Medicine 43 (9), 824-828, 2004

    The Japanese Society of Internal Medicine

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