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August 4, 1962

Fibrous Mesothelioma with Hypoglycemic Psychosis and Coma

Author Affiliations

Norfolk, Va.
From the departments of medicine and surgery, the Public Health Service Hospital, Bureau of Medical Services, Public Health Service, U.S. Department of Health, Education, and Welfare.; Dr. Belcher is now at the Public Health Service Hospital, San Francisco. Dr. Shuttleworth is now in Clearwater, Fla.

JAMA. 1962;181(5):380-385. doi:10.1001/jama.1962.03050310020004

The syndrome of large nonpancreatic tumors with hypoglycemia has been recognized as a clinical entity. A spindletype of cell predominates in these tumors; they are located in the thorax or abdomen and generally attain a massive size before symptoms of hypoglycemia appear. The patient here described, when admitted to the hospital, had a large abdominal mass; he was maniacal and later became comatose. Intravenous administration of glucose caused striking temporary improvement. Surgical extirpation of a large retroperitoneal mesothelioma was followed by a lasting stabilization of the blood sugar and glucose tolerance within normal limits. Biologic assay of tumor tissue and plasma in this case did not reveal any increased insulin-like activity.