Insulin-like Growth Factor II and the Riddle of Tumor-Induced Hypoglycemia

Abstract

Sometimes a problem in pathophysiology captures our imagination out of proportion to its frequency in clinical practice. The syndrome of tumor-induced hypoglycemia, in which hypoglycemia occurs in association with non-islet-cell tumors, is a case in point. In this syndrome, we encounter a dramatic clinical presentation of an uncommon group of tumors whose pathophysiology has until recently defied explanation. Often, it is the hypoglycemia that brings the patient to medical attention. Because the symptoms of neuroglycopenia, such as coma, seizures, or focal neurologic abnormalities, predominate over symptoms of adrenergic activation, the clinical findings resemble those of an insulinoma. The tumors most . . .