Journal of Gastrointestinal Cancer

, Volume 41, Issue 3, pp 209–211 | Cite as

Hypoglycemia, an Atypical Early Sign of Hepatocellular Carcinoma

  • MariaLuisa Sorlini
  • Federica Benini
  • Primarosa Cravarezza
  • Giuseppe RomanelliEmail author
Brief Communication



Hypoglycemia is extremely uncommon as the first presentation of hepatocellular carcinoma, and it occurs predominantly as a paraneoplastic manifestation.


We report a case of a 38-year-old-man positive for hepatitis B surface antigen with high-serum viremia who presented with symptoms of acute severe hypoglycemia.


Laboratory tests confirmed hypoglycemia (serum glucose 1.54 mmol/L) with undetectable serum-C peptide (<0.5 µIU/mL) and slightly increased serum insulin concentration (35 µIU/mL). Alpha-fetoprotein serum level was 75,625 ng/mL. Abdominal ultrasonography and computed tomography revealed a big vascularized mass of 13 cm in diameter occupying most of the right lobe of the liver and an 18F-fluoro-2-deoxy-D-glucose positron-emission tomography revealed a predominant uptake of glucose by the tumor mass.


These findings indicate that hepatocellular carcinoma-associated hypoglycemia may be due exclusively to increased glucose utilization by the tumor mass.


hypoglycemia hepatocellular carcinoma tumor mass hepatitis B virus 


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • MariaLuisa Sorlini
    • 1
  • Federica Benini
    • 2
  • Primarosa Cravarezza
    • 1
  • Giuseppe Romanelli
    • 1
    Email author
  1. 1.1st Internal Medicine UnitUniversity and Spedali CiviliBresciaItaly
  2. 2.Gastroenterology UnitUniversity and Spedali CiviliBresciaItaly

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