Abstract
Abstract. A patient with a large intrathoracic tumour associated with hypoglycemic attacks and whose fasting glucose levels were frequently below 30 mg/100 ml is described. The immunoreactive insulin (IRI) level during the hypoglycemic attacks and fasting was less than 5 μU/ml. The oral glucose tolerance test was normal. Glucagon gave a subnormal increase in blood glucose and no increase in serum IRI levels. Diazoxide did not reduce the frequency of attacks. The hypoglycemic attacks subsided after removal of a 5 kg cell‐rich mesenchymal tumour, which was probably a neurofibroma. The IRI concentration in the primary tumour extract was 0.05% of that found in extract from normal pancreatic tissue, and only 0.0005–0.1 % of that reported for insulinomas. On Sephadex‐LH gel filtration the low IRI activity was not eluted as insulin or proinsulin. All findings support the view that the hypoglycemia was not caused by insulin production by the tumour. Other possible causes are discussed.
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