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October 1963

Hypoglycemia in a Patient With a Fibrous TumorStudies of the Mechanism of the Hypoglycemia

Arch Intern Med. 1963;112(4):589-593. doi:10.1001/archinte.1963.03860040185018

It now is well known that patients with large tumors of mesenchymal and sometimes of epithelial origin may have severe hypoglycemia.1 In spite of intensive study, however, there still is no general agreement concerning the mechanism by which such tumors produce hypoglycemia. Previously, we reported a patient in whom hypoglycemia had been associated with a massive intra-abdominal mesothelial cell sarcoma.2 Production of an "insulin-like" factor by the tumor could not be demonstrated, and indirect evidence suggested that excessive glucose consumption by the tumor was the underlying cause of the hypoglycemia. Since the tumor had been frozen before study, our failure to demonstrate active glucose uptake by slices of tumor could not be considered conclusive.

We now have had the opportunity to study fresh tumor slices from another patient with this interesting condition and to carry out certain studies not available to us at the time of the previous