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Ovarian tumors secreting insulin

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Abstract

Combined ovarian germ cell and neuroendocrine tumors are rare. Only few cases of hyperinsulinism due to ovarian ectopic secretion have been hypothesized in the literature. An ovarian tumor was diagnosed in a 76-year-old woman, referred to our department for recurrent hypoglycemia with hyperinsulinism. In vivo tests, in particular fasting test, rapid calcium infusion test, and Octreotide test were performed. Ectopic hyperinsulinemic hypoglycemia was demonstrated in vivo and hypoglycemia disappeared after hysteroadnexectomy. Histological exam revealed an ovarian germ cell tumor with neuroendocrine and Yolk sac differentiation, while immunostaining showed insulin positivity in neuroendocrine cells. A cell culture was obtained by tumoral cells, testing Everolimus, and Pasireotide. Insulin was detected in cell culture medium and Everolimus and Pasireotide demonstrated their potentiality in reducing insulin secretion, more than controlling cell viability. Nine cases of hyperinsulinism due to ovarian ectopic secretion reported in literature have been reviewed. These data confirm the ovarian tissue potentiality to induce hyperinsulinemic hypoglycemic syndrome after neoplastic transformation.

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Acknowledgments

The authors thank Dr. Vincenza Guzzardo for technical assistance.

Conflict of interest

Dr. Maffei has received unrestricted Grants from Novartis, Italfarmaco, and Ipsen and has been a member of Novartis, Italfarmaco, and Ipsen advisory boards.

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Authors and Affiliations

  1. Internal Medicine 3, Department of Medicine, University of Padua, Via Giustiniani 2, 35100, Padua, Italy

    Marialberta Battocchio, Eugenio De Carlo, Francesca Dassie, Roberto Mioni, Andrea Rebellato, Francesco Fallo, Chiara Martini, Roberto Vettor & Pietro Maffei

  2. Surgical Pathology and Cytopathology Unit, DiMED, University of Padua, Padua, Italy

    Silvia Chiarelli & Mariangela Trento

  3. Section of Endocrinology and Internal Medicine, Department of Medical Science, University of Ferrara, Ferrara, Italy

    Maria Chiara Zatelli, Maria Rosaria Ambrosio & Ettore Degli Uberti

  4. DiSCOG, University of Padua, Padua, Italy

    Claudio Pasquali

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  1. Marialberta Battocchio
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Correspondence to Marialberta Battocchio.

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Battocchio, M., Zatelli, M.C., Chiarelli, S. et al. Ovarian tumors secreting insulin. Endocrine 49, 611–619 (2015). https://doi.org/10.1007/s12020-015-0605-y

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