Ectopic insulin secreting neuroendocrine tumor of kidney with recurrent hypoglycemia: a diagnostic dilemma

BMC Endocrine Disorders

Chandra Sekhar Bal³  Mehar C Sharma¹  Amlesh Seth⁴  Chandan J Das⁵  MohdAshraf Ganie²  VP Jyotsna²  Atul Dhingra²  S Ramkumar² 

[1] Departments of Pathology, All India Institute of Medical Sciences, New Delhi, India;Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India;Departments of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India;Departments of Urology, All India Institute of Medical Sciences, New Delhi, India;Departments of Radiology, All India Institute of Medical Sciences, New Delhi, India

关键词: 99mTc-HYNICTOC scan;    68Ga-Dotanoc scan;    Renal tumour;    Carcinoid tumor;    Insulinoma;    Neuroendocrine tumour;    Hyperinsulinemic hypoglycemia;   

Others  :  864931
DOI  :  10.1186/1472-6823-14-36

 received in 2013-12-23, accepted in 2014-03-06,  发布年份 2014

【 摘 要 】

Background

Hypoglycemia secondary to ectopic insulin secretion of non-pancreatic tumors is rare.

Case presentation

We describe a middle aged woman with recurrent hypoglycemia. On evaluation, she was detected to have hyperinsulinemic hypoglycemia and right sided renal mass lesion. 68Ga-Dotanoc and 99mTc-HYNICTOC scans confirmed the intrarenal mass to be of neuroendocrine origin. Right nephrectomy was done and it turned out to be an insulin secreting neuroendocrine tumour. Neuroendocrine nature of this tumour was further confirmed by ultra-structural examination. Her hypoglycemia did not recur after resection of this tumour.

Conclusion

Few cases of ectopic insulin secretion have been reported though some are not proven convincingly. This case addresses all the issues raised in previous case reports and proves by clinical, laboratory, functional imaging and immunohistochemical analysis that ectopic origin of insulin by non-pancreatic tumors does occur. To our knowledge, this is the first reported case of ectopic insulinoma arising from the kidney.

【 授权许可】

   
2014 Ramkumar et al.; licensee BioMed Central Ltd.

【 图 表 】

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