IGF-II産生非膵島細胞腫瘍性低血糖症を発症した上顎歯肉癌の1例

• Published in: 日本口腔外科学会雑誌 Vol. 62; no. 9; pp. 448 - 453
• Main Authors: 河奈, 裕正, 莇生田, 整治, 山田, 有佳, 相馬, 智也, 宮下, 英高, 森, 泰昌
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.09.2016
• Subjects: インスリン様成長因子−II; 口腔癌; 非膵島細胞腫瘍性低血糖症
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.62.448

Non-islet-cell tumor hypoglycemia (NICTH), a condition characterized by recurrent episodes of hypoglycemia, rarely occurs in association with oral cancer. Here, we report a case of carcinoma of the maxillary gingiva with NICTH caused by paraneoplastic production of insulin-like growth factor II (IGF-II). A 72-year-old man with a painful swelling in the left maxillary region was referred to our hospital. A mass with induration was observed in the buccal and palatal regions from the first premolar to the second molar. The clinical diagnosis was carcinoma of the maxillary gingiva, and a biopsy revealed squamous cell carcinoma. The patient received concurrent radiation and chemotherapy with cisplatin. Three weeks after the completion of treatment, three episodes of hypoglycemia developed despite normal intake of meals. On the basis of the results of endocrinological examinations, typical diseases causing hypoglycemia, such as insulinoma and adrenal insufficiency, were ruled out. Furthermore, decreased IGF-I levels were found, which indirectly revealed an increase in IGF-II levels. On the basis of these findings, we diagnosed this case as carcinoma of the maxillary gingiva with NICTH. Continuous intravenous glucose infusion was needed for 3 months from the diagnosis of NICTH until death. NICTH should be borne in mind as one of the complications that can occur during treatment of oral cancer.