Department of Endocrine Neoplasia and Hormonal Disorders, Unit 1461, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
Endocrine. 2010 Feb;37(1):209-12. doi: 10.1007/s12020-009-9300-1. Epub 2010 Jan 5.
We present a patient with metastatic pheochromocytoma, who developed progressive and fatal hypoglycemia most likely secondary to direct tumor glucose consumption that did not respond to high-dose glucose infusion, corticosteroids, or glucagon therapy. The pattern of glucose uptake on (18)F-2-fluoro-2-deoxy-D-glucose positron emission tomography, with preferential tumor glucose uptake in association with a marked reduction in normal uptake in the heart, muscles, and brain, is highly suggestive of direct consumption of glucose by the tumor rather than insulin-like growth factor-2 mediated hypoglycemia. In patients with large-volume metastatic malignancies, direct tumor glucose consumption should be considered in the differential diagnosis of hypoglycemia. Nuclear medicine imaging techniques can illustrate the pathophysiology of hypoglycemia in such cases.
我们报告了一例转移性嗜铬细胞瘤患者，其发生了进行性和致命性低血糖，很可能继发于肿瘤直接摄取葡萄糖，而高剂量葡萄糖输注、皮质类固醇或胰高血糖素治疗对此无效。（18）F-2-氟-2-脱氧-D-葡萄糖正电子发射断层扫描显示葡萄糖摄取模式，肿瘤优先摄取葡萄糖，同时心脏、肌肉和大脑的正常摄取明显减少，强烈提示肿瘤直接摄取葡萄糖，而不是胰岛素样生长因子-2介导的低血糖。在患有大体积转移性恶性肿瘤的患者中，在低血糖的鉴别诊断中应考虑肿瘤直接摄取葡萄糖。核医学成像技术可阐明此类情况下低血糖的病理生理学。
