Malignant mesothelioma associated with hypoglycemia; report of a case

Our plain-English summary of Malignant mesothelioma associated with hypoglycemia; report of a case, by K.A. Nesbitt, J.T. Boswell, M.A. Dejesusgonzales, et al (American Journal of Clinical Pathology, 1958).

The study

• Authors: K.A. Nesbitt, J.T. Boswell, M.A. Dejesusgonzales, S.S. Sarkisian
• Journal: American Journal of Clinical Pathology
• Published: 1958;30(2):148-57
• Type of article: Case report
• Cited by: 31 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A case of malignant mesothelioma of the peritoneal cavity associated with hypoglycemia of convulsive levels in a former mild diabetic is presented. The subject of nonpancreatic tumors associated with hypoglycemia is briefly reviewed. It is suggested that the term "mesodermal" might be more generally applicable than "fibrogenic" in classifying a group of rare tumors associated with hypoglycemia and now of considerable interest. It is important that pathologists and clinicians be on the alert to bio-assay tumor tissue in similar future cases for insulin activity and insulinase-inhibitors. Such additional studies are essential for a better understanding of the relationships of carbohydrate metabolism and these neoplasms.

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

In plain English

This 1958 case report, from the U.S. Naval Hospital, St. Albans, New York, described one 42-year-old white man who had earlier had mild diabetes, later controlled by diet alone. After weight loss, back pain and bowel symptoms, surgery found tumor coating his abdominal lining. Biopsies were reported as diffuse malignant mesothelioma of the peritoneal cavity. He received 100 mc of radioactive gold into the abdomen. Later he developed low blood sugar (hypoglycemia), with readings of 58 and 52 mg per 100 ml, then 35 mg per 100 ml at the time of a convulsion. Intravenous 10 per cent glucose at 3000 ml daily did not raise his blood sugar above 65 mg per 100 ml except once, and he died. At autopsy the tumor encased most abdominal organs and had spread to the right lung's surface. Tumor was attached to the front of the pancreas, but its tissue showed no gross abnormality when cut. The authors suggested calling such tumors "mesodermal tumors associated with hypoglycemia." They noted pituitary disease was not completely ruled out. The article does not mention asbestos or any 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 (single patient), with a brief review of earlier reports of hypoglycemia with tumors outside the pancreas
• Who was studied: One 42-year-old white man with a history of mild diabetes mellitus, treated at the U.S. Naval Hospital, St. Albans, New York
• Exposure: Not reported. The article does not mention asbestos, fiber types, or any occupational or environmental exposure.
• Main results:
  • Biopsies taken at exploratory surgery of the abdomen were reported as diffuse malignant mesothelioma.
  • The patient received 100 mc of radioactive gold (Au198) into the peritoneal cavity on the 21st hospital day.
  • The patient developed low blood sugar. Two specimens measured 58 and 52 mg per 100 ml, and the reading was 35 mg per 100 ml at the time of a convulsion.
  • Intravenous 10 per cent glucose at 3000 ml daily did not raise the patient's blood sugar above 65 mg per 100 ml except on one occasion. The patient died.
  • At autopsy, the tumor had spread from the peritoneal cavity through the diaphragm to the pleural surface of the right lung.
  • At autopsy, the tumor-thickened peritoneum was attached to the front surface of the pancreas, but the body and tail were grossly uninvolved, and on sectioning the pancreatic tissue showed no gross abnormalities.
  • Under the microscope, the tumor was considered typical of a malignant mesothelioma of the diffuse tubular type.
  • Apart from one earlier case that another group regarded as a type of fibrous mesothelioma, the authors found no other reports of mesothelioma associated with hypoglycemia.
• The authors' conclusion: The authors noted that the earlier reported tumors and this mesothelioma are probably all of mesodermal origin. They suggested the term "mesodermal tumors associated with hypoglycemia" as a more suitable classification than "fibrogenic." They also urged that tumor tissue in similar future cases be bio-assayed for insulin activity and insulinase inhibitors.
• Limitations the authors state:
  • The authors state that pituitary disease was not completely ruled out in this case, although they considered it unlikely.
  • The brain and pituitary were not examined at autopsy because permission to examine the head was not granted.
  • Enzymatic studies of the tumor were not done.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Peritoneal Cavity, Fibrogenic, Neoplasm.

Related studies

• Asbestosis and abdominal neoplasms — E.E. Keal (1960)
• 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)
• Giant pleural mesothelioma associated with hypoglycemia and hyperthyroidism — G.J. Devroede, A.F. Tirol (1968)
• Diffuse pleural mesothelioma and asbestos exposure in the North Western Cape Province — J.C. Wagner, C.A. Sleggs, et al. (1960)
• Mesothelioma of the pelvic peritoneum resembling papillary cystadenocarcinoma of the ovary; case report — M. Swerdlow (1959)

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