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Case Report
 
Remarkable body weight gain in a patient in the terminal phase of gastric carcinoma secondary to ‘big IGF-II’— producing tumor
Genta Ishikawa1, Naoki Nishimura1, Teruhiko Yoshida1, Atsushi Kitamura1, Yasuhiko Yamano1, Yutaka Tomishima1, Torahiko Jinta1, Koyu Suzuki2, Naohiko Chohnabayashi2
1Division of Pulmonary Medicine, St. Luke’s International Hospital.
2Department of Pathology, St. Luke’s International Hospital.

doi:10.5348/ijcri-2013-07-336-10

Address correspondence to:
Genta Ishikawa, St. Luke's International Hospital
Akashi-cho 9-1, Chuo-ku
Division of Pulmonary Medicine
Tokyo, 104-8560
Japan
Phone: +81-3-3541-5151
Fax: +81-3-3544-0649
Email: gentahot@hotmail.com

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How to cite this article:
Ishikawa G, Nishimura N, Yoshida T, Kitamura A, Yamano Y, Tomishima Y, Jinta T, Suzuki K, Chohnabayashi N. Remarkable body weight gain in a patient in the terminal phase of gastric carcinoma secondary to ‘big IGF-II’— producing tumor. International Journal of Case Reports and Images 2013;4(7):380–383.


Abstract
Introduction: Weight loss as a result of cachexia with malignancy is frequently encountered in clinical practice. However, previous reports have not demonstrated weight gain in terminal phase of malignancy.
Case Report: We report a 69-year-old male admitted with an exacerbation of interstitial pneumonia and multiple metastases of relapsed gastric adenocarcinoma complicated with refractory hypoglycemia. He had gained approximately 10 kg weight with an acromegaloid appearance in a one-month period before admission. The presence of big insulin-like growth fact II (Big IGF-II) in his blood and an immunohistochemical study on the tumor cells confirmed a diagnosis of non-islet cell tumor hypoglycemia.
Conclusion: This report possibly illustrates an unreported differential diagnosis of weight gain in terminal phase of malignancy.

Keywords: Gastric carcinoma, Non-islet cell tumor hypoglycemia (NICTH), Body weight gain


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Author Contributions
Genta Ishikawa – Conception and design, Acquisition of data, Analysis and Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Naoki Nishimura – Conception and design, Acquisition of data, Analysis and Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Teruhiko Yoshida – Conception and design, Acquisition of data, Analysis and Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Atsushi Kitamura – Conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Yasuhiko Yamano – Conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Yutaka Tomishima – Conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Torahiko Jinta – Conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Koyu Suzuki- Conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Naohiko Chohnabayashi – Conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
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The corresponding author is the guarantor of submission.
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Conflict of interest
Authors declare no conflict of interest.
Copyright
© Genta Ishikawa et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)