Benign pleural mesothelioma with tumour-induced hypoglycaemia

Our plain-English summary of Benign pleural mesothelioma with tumour-induced hypoglycaemia, by K.R. Burgess, J. Rutland, G.E. Marlin, et al (Australian and New Zealand Journal of Medicine, 1982).

The study

• Authors: K.R. Burgess, J. Rutland, G.E. Marlin, P.J. Maloney, D.C. Perry
• Journal: Australian and New Zealand Journal of Medicine
• Published: 1982;12(1):70-2
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A patient with a rare tumour, benign pleural mesothelioma, associated with hypoglycaemia is reported. He presented with a neuropsychiatric disturbance and was successfully treated by surgical removal of the tumour. Glucose tolerance tests and serum insulin levels suggested secretion of an insulin-like substance by the tumour. Glucose consumption by the tumour may have contributed to the hypoglycaemia.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This case report from Concord Hospital, Sydney, described one man, a retired motor mechanic and smoker, whose benign pleural mesothelioma was associated with low blood sugar (hypoglycaemia). He had early-morning episodes of agitation, confusion and convulsions. A blood glucose level of 2.2 mmol/l (normal range 3.3 to 5.5 mmol/l) confirmed hypoglycaemia. Tests showed that his usual insulin response to a glucose load was suppressed. At surgery, a large tumour was found arising from the pleura of the right lower lobe of the lung. It weighed 2800 g and measured 22 x 19 x 13 cm, and tissue examination showed a benign pleural mesothelioma. One month after surgery his glucose tolerance was impaired. Seven years later he remained well, with normal glucose and insulin tests and no sign of the tumour returning. The authors suggested the tumour could have produced an insulin-like substance and that its own glucose use may have contributed. The article did not report any asbestos exposure for this patient. The authors' introduction described benign pleural mesothelioma as unrelated to asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (one patient)
• Who was studied: One man, a retired motor mechanic with a 30 pack-year smoking history and mild chronic bronchitis, who had lived in country areas of New South Wales and was treated at Concord Hospital, Sydney, from 1970 to 1971 and followed for seven years
• Exposure: No asbestos exposure is described for this patient. In their introduction, the authors state that benign pleural mesothelioma is unrelated to asbestos exposure. The study concerns the tumour's association with hypoglycaemia, not an exposure.
• Main results:
  • Hypoglycaemia was confirmed in the patient by a blood glucose level of 2.2 mmol/l (normal range 3.3 to 5.5 mmol/l)
  • Before surgery, insulin levels measured during a glucose tolerance test showed that the patient's usual insulin response to a glucose load was suppressed
  • At thoracotomy in February 1971, a large tumour was found arising from the visceral pleura of the right lower lobe
  • The tumour weighed 2800 g
  • The tumour measured 22 x 19 x 13 cm
  • Histology showed a benign pleural mesothelioma with an area of necrosis and mottled calcification
  • A glucose tolerance test one month after surgery showed impaired glucose tolerance
  • Lung function after surgery was 1.5 l (FEV1) and 2.0 l (VC) before bronchodilator, compared with 0.6 l (FEV1) and 1.2 l (VC) before surgery; the authors described this as considerable improvement
  • Seven years after surgery the patient remained well, his glucose tolerance test and insulin response were normal, and his chest radiograph showed no evidence of recurrent tumour
  • Using the highest reported glucose consumption rate from another study, the authors estimated that the patient consumed 760 g of glucose per day (560 g by the tumour and 200 g basal body use), similar to a reserve capacity of 800 g per day. They suggested this may have been a factor.
• The authors' conclusion: The authors concluded that the hypoglycaemia could have been caused by the tumour producing an insulin-like substance, which the glucose tolerance test results would support. They added that glucose consumption by the tumour may have contributed.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma.

Related studies

• Causes and evaluation of tumor-induced hypoglycemia — S.C. Immerman, S.F. Sener, et al. (1982)
• Solitary fibrous tumor of the pleura. An immunohistochemical, electron microscopic and tissue culture study of a tumor producing insulin-like growth factor I in a patient with hypoglycemia — E.H. Strøm, F. Skjørten, et al. (1991)
• Malignant mesothelioma associated with hypoglycemia; report of a case — K.A. Nesbitt, J.T. Boswell, et al. (1958)
• Giant pleural mesothelioma associated with hypoglycemia and hyperthyroidism — G.J. Devroede, A.F. Tirol (1968)
• Patterns of chromosomal imbalances in benign solitary fibrous tumours of the pleura — M. Krismann, H. Adams, et al. (2000)
• Diagnostic usefulness of tumour marker levels in pleural effusions of malignant and benign origin — F. Kuralay, Z. Tokgöz, et al. (2000)

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