Nida UYAR, Mehmet EREN, Ahmet UYANIKOĞLU, Merve TATLIGÜN, Tevfik SABUNCU

Hipoglisemi ile Prezente Olan Hepatoselüler Karsinom Olgusu

Hipoglisemi birçok nedene bağlı gelişebilmektedir ve bu nedenler arasında maligniteler de yer almaktadır. Sıklıkla adacık hücre malignitelerinde gözlenmekle birlikte hepatoselüler karsinom gibi malignitelerde de hipoglisemi gözlenebilmektedir. Dirençli hipoglisemi ile başvuran olgumuzda öncelikle endokrinolojik sebepler düşünülmüş, ancak etiyoloji tespit edilememiştir. Muayenesinde splenomegali tespit edilen hastanın batın ultrasonografisi ve dinamik magnetik rezonans görüntülemesinde multifokal hepatoselüler karsinom saptanmıştır. Hipoglisemi ile prezente olan hepatoselüler karsinomlu orta yaş erkek hasta sunulmuştur.

Anahtar Kelimeler:

hipoglisemi, hepatoselüler karsinom, splenomegali

PDF

___

1) 1) Kahn CR. Theriddle of tumour hypoglycaemia revisited. J Clin Endocrinol Metab 1980;9:335-60.
2) Luo JC, Hwang SJ, Wu JC, Lai CR, Li CP, Chang FY, et al. Clinical characteristics and prognosis of hepatocellular carcinoma patients with paraneoplastic syndromes. Hepatogastroenterology. 2002; 49: 1315‑1319.
3) Saigal S, Nandeesh HP, Malhotra V and Sarin SK: A case of hepatocellular carcinoma associated with trouble some hypoglycemia: management bycyto reductionusing percutaneous ethanol injection. Am J Gastroenterol. 1998;93:1380‑1381.
4) Tangkijvanich P, Thong-Ngam D, Kullavanijaya P, Suwangool P. Fibrolamellar hepatocellularcarcinoma in a Thaiman who presented with hypoglycemia: case reportand review of literature. J MedAssocThai. 2000; 83:809.
5) T.W. Bodnar,M. J. Acevedo, and M. Pietropaolo, “Management of non-islet-cell tumor hypoglycemia: a clinicalreview,” Journal of Clinical Endocrinology and Metabolism. 2014;99(3):713–722.
6) Marks V &Teale JD Tumour sproducing hypoglycaemia. Endocrine-Related Cancer. 1998;5: 111–129.
7) S. Nikeghbalian, A. Bananzadeh, and H. Yarmohammadi,“Hypoglycemia, the first presenting sign of hepatocellular carcinoma,” Saudi Medical Journal. 2006;27(3):387-388.
8) R. T. Yeung, “Hypoglycaemia in hepatocellularcarcinoma: a review,” Hong Kong MedicalJournal. 1997;3:297–301.
9) Kalebi AY, Hale MJ, Wong ML, Hoffman T andMurray J: Surgically cured hypoglycemia secondary to pleuralsolitary fibrous tumour: case reportand update review on the Doege‑Potter syndrome. J CardiothoracSurg. 2009;4:45.
10) Le Roith D: Tumor‑induced hypoglycemia. N Engl J Med.1999;341: 757‑758.
11) Hoff AO and Vassilopoulou‑Sellin R: The role of glucagon administration in the diagnosis and treatment of patients with tumor hypoglycemia. Cancer 1998;82: 1585‑1592.