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2014 ; 14
(ä): 36
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Ectopic insulin secreting neuroendocrine tumor of kidney with recurrent
hypoglycemia: a diagnostic dilemma
#MMPMID24741994
Ramkumar S
; Dhingra A
; Jyotsna V
; Ganie MA
; Das CJ
; Seth A
; Sharma MC
; Bal CS
BMC Endocr Disord
2014[Apr]; 14
(ä): 36
PMID24741994
show ga
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.