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Nishiwaki N, Mikuriya Y, Takatsu F, Ochiai R, Kakishita T, Kobayashi N, Kobatake T, Hato S, Teramoto N, Nagao M, Fukuda I, Ohta K. Surgical resection of a retroperitoneal liposarcoma producing insulin-like growth factor II: a case report. Surg Case Rep 2023; 9:19. [PMID: 36752872 PMCID: PMC9908783 DOI: 10.1186/s40792-023-01589-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/11/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Tumor-produced high molecular weight insulin-like growth factor-II (big insulin-like growth factor-II) is considered to cause non-islet cell tumor hypoglycemia. This paper presents a case of surgically resected retroperitoneal liposarcoma that produced big insulin-like growth factor-II. CASE PRESENTATION Here, we report the case of a 62-year-old woman who presented with an abdominal mass and hypoglycemia. Non-islet cell tumor hypoglycemia due to retroperitoneal liposarcoma was suspected. After complete resection of the tumor, the patient's hypoglycemia improved and big insulin-like growth factor-II disappeared in the molecular weight analysis of serum insulin-like growth factor-II by western blotting. The patient had no tumor recurrence or reappearance of hypoglycemia 16 months after the operation without any adjuvant therapy. CONCLUSIONS Although insulin-like growth factor-II-producing tumors are generally large and difficult to operate on, surgical resection is currently the most effective and only treatment; thus, it is essential to attempt resection aggressively.
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Affiliation(s)
- Noriyuki Nishiwaki
- Department of Gastroenterological Surgery, National Hospital Organization, Shikoku Cancer Center, 160, Ko, Minamiumemoto-machi, Matsuyama-shi, Ehime-Ken, 791-0280, Japan.
| | - Yoshihiro Mikuriya
- grid.415740.30000 0004 0618 8403Department of Gastroenterological Surgery, National Hospital Organization, Shikoku Cancer Center, 160, Ko, Minamiumemoto-machi, Matsuyama-shi, Ehime-Ken 791-0280 Japan
| | - Fumiaki Takatsu
- grid.415740.30000 0004 0618 8403Department of Gastroenterological Surgery, National Hospital Organization, Shikoku Cancer Center, 160, Ko, Minamiumemoto-machi, Matsuyama-shi, Ehime-Ken 791-0280 Japan
| | - Ryoji Ochiai
- grid.415740.30000 0004 0618 8403Department of Gastroenterological Surgery, National Hospital Organization, Shikoku Cancer Center, 160, Ko, Minamiumemoto-machi, Matsuyama-shi, Ehime-Ken 791-0280 Japan
| | - Tomokazu Kakishita
- grid.415740.30000 0004 0618 8403Department of Gastroenterological Surgery, National Hospital Organization, Shikoku Cancer Center, 160, Ko, Minamiumemoto-machi, Matsuyama-shi, Ehime-Ken 791-0280 Japan
| | - Naruyuki Kobayashi
- grid.415740.30000 0004 0618 8403Department of Gastroenterological Surgery, National Hospital Organization, Shikoku Cancer Center, 160, Ko, Minamiumemoto-machi, Matsuyama-shi, Ehime-Ken 791-0280 Japan
| | - Takaya Kobatake
- grid.415740.30000 0004 0618 8403Department of Gastroenterological Surgery, National Hospital Organization, Shikoku Cancer Center, 160, Ko, Minamiumemoto-machi, Matsuyama-shi, Ehime-Ken 791-0280 Japan
| | - Shinji Hato
- grid.415740.30000 0004 0618 8403Department of Gastroenterological Surgery, National Hospital Organization, Shikoku Cancer Center, 160, Ko, Minamiumemoto-machi, Matsuyama-shi, Ehime-Ken 791-0280 Japan
| | - Norihiro Teramoto
- grid.415740.30000 0004 0618 8403Department of Pathology, National Hospital Organization, Shikoku Cancer Center, 160, Ko, Minamiumemoto-machi, Matsuyama-shi, Ehime-Ken 791-0280 Japan
| | - Mototsugu Nagao
- grid.410821.e0000 0001 2173 8328Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Izumi Fukuda
- grid.410821.e0000 0001 2173 8328Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Koji Ohta
- grid.415740.30000 0004 0618 8403Department of Gastroenterological Surgery, National Hospital Organization, Shikoku Cancer Center, 160, Ko, Minamiumemoto-machi, Matsuyama-shi, Ehime-Ken 791-0280 Japan
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Abstract
INTRODUCTION Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and a significant proportion (20-40%) of patients with HCC develop paraneoplastic syndromes (PNS). Despite this, there is a paucity of clinical evidence regarding PNS in HCC. AREAS COVERED A systematic search was performed to identify relevant case studies regarding PNS in HCC. Another search was conducted to identify studies that evaluated the impact of PNS on survival outcomes in HCC. Since there are currently no international guidelines for PNS in HCC, this review aims to provide comprehensive summaries and recommendations of PNS in HCC, including the pathophysiology, clinical features, diagnostic approach, and management, so that clinicians remain guided in caring for HCC patients with PNS. In general, PNS are associated with poorer survival outcomes and negative prognostic markers of HCC. EXPERT OPINION The presence of PNS has a significant influence on survival rates and clinical outcomes of patients with HCC. They contribute to significant morbidity, influencing patients' quality of life and fitness for curative and palliative therapies. Therefore, it is paramount for PNS to be integrated into routine investigations after diagnosing HCC to guide further management and prognostication of the disease.
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Affiliation(s)
- Yuki Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheong Wei Terence Huey
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Hepato-Pancreatico-Biliary Surgery, Department of Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Vishalkumar Girishchandra Shelat
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Hepato-Pancreatico-Biliary Surgery, Department of Surgery, Tan Tock Seng Hospital, Singapore, Singapore
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Well-differentiated liposarcoma causing non-islet cell tumor hypoglycemia. Int Cancer Conf J 2022; 11:210-214. [PMID: 35669897 PMCID: PMC9163218 DOI: 10.1007/s13691-022-00550-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/06/2022] [Indexed: 10/18/2022] Open
Abstract
Non-islet cell tumor hypoglycemia (NICTH) is a paraneoplastic syndrome that causes severe hypoglycemia. The tumor involved produces high-molecular-weight insulin-like growth factor-II (IGF-II). NICTH can be caused by various benign and malignant tumors. However, NICTH due to liposarcoma (LPS) is rare. A 38-year-old man was brought to the hospital emergency department with complaints of vomiting and unconsciousness. His abdomen was distended, and a large tumor was palpable. He had severe hypoglycemia that required continuous glucose infusion. Radiological examination revealed a large 40-cm mass that filled the abdominal cavity, and LPS of the mesentery was suspected. Laboratory data showed low levels of insulin, C-peptide, and IGF-I concentrations. Subsequently, an LPS-induced NICTH was suspected. Complete resection of the tumor and the encased small intestine was performed. The pathological diagnosis was well-differentiated liposarcoma (WDLPS). The Western immunoblot showed that the high-molecular-weight IGF-II confirmed in the serum preoperatively, had almost disappeared postoperatively. Based on these findings, NICTH caused by a WDLPS was diagnosed. The postoperative course was uneventful. In the last 4 years since the primary operation, the patient had not experienced further hypoglycemia symptoms. Here, we report a case of NICTH caused by a large WDLPS. NICTH should be considered in patients with both severe hypoglycemia and large tumors. In these cases, appropriate treatment including semi-urgent surgery should be provided.
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Giuliani A, Matacchione G, Ramini D, Di Rosa M, Bonfigli AR, Sabbatinelli J, Monsurrò V, Recchioni R, Marcheselli F, Marchegiani F, Piacenza F, Cardelli M, Galeazzi R, Pomponio G, Ferrarini A, Gabrielli A, Svegliati Baroni S, Moretti M, Sarzani R, Giordano P, Cherubini A, Corsonello A, Antonicelli R, Procopio AD, Ferracin M, Bonafè M, Lattanzio F, Olivieri F. Circulating miR-320b and miR-483-5p levels are associated with COVID-19 in-hospital mortality. Mech Ageing Dev 2022; 202:111636. [PMID: 35122770 PMCID: PMC8809668 DOI: 10.1016/j.mad.2022.111636] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/13/2022] [Accepted: 01/31/2022] [Indexed: 02/08/2023]
Abstract
The stratification of mortality risk in COVID-19 patients remains extremely challenging for physicians, especially in older patients. Innovative minimally invasive molecular biomarkers are needed to improve the prediction of mortality risk and better customize patient management. In this study, aimed at identifying circulating miRNAs associated with the risk of COVID-19 in-hospital mortality, we analyzed serum samples of 12 COVID-19 patients by small RNA-seq and validated the findings in an independent cohort of 116 COVID-19 patients by qRT-PCR. Thirty-four significantly deregulated miRNAs, 25 downregulated and 9 upregulated in deceased COVID-19 patients compared to survivors, were identified in the discovery cohort. Based on the highest fold-changes and on the highest expression levels, 5 of these 34 miRNAs were selected for the analysis in the validation cohort. MiR-320b and miR-483-5p were confirmed to be significantly hyper-expressed in deceased patients compared to survived ones. Kaplan-Meier and Cox regression models, adjusted for relevant confounders, confirmed that patients with the 20% highest miR-320b and miR-483-5p serum levels had three-fold increased risk to die during in-hospital stay for COVID-19. In conclusion, high levels of circulating miR-320b and miR-483-5p can be useful as minimally invasive biomarkers to stratify older COVID-19 patients with an increased risk of in-hospital mortality.
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Affiliation(s)
- Angelica Giuliani
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Giulia Matacchione
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Deborah Ramini
- Center of Clinical Pathology and Innovative Therapy, IRCCS INRCA, Ancona, Italy
| | - Mirko Di Rosa
- Center of Clinical Pathology and Innovative Therapy, IRCCS INRCA, Ancona, Italy
| | | | - Jacopo Sabbatinelli
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy; SOD Medicina di Laboratorio, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy.
| | | | - Rina Recchioni
- Center of Clinical Pathology and Innovative Therapy, IRCCS INRCA, Ancona, Italy
| | | | | | - Francesco Piacenza
- Advanced Technology Center for Aging Research, Scientific Technological Area, IRCCS INRCA, Ancona, Italy
| | - Maurizio Cardelli
- Advanced Technology Center for Aging Research, Scientific Technological Area, IRCCS INRCA, Ancona, Italy
| | - Roberta Galeazzi
- Clinical Laboratory and Molecular Diagnostic, Italian National Research Center on Aging, IRCCS INRCA, Ancona, Italy
| | - Giovanni Pomponio
- Clinica Medica, Department of Internal Medicine, Ospedali Riuniti, Ancona, Italy
| | - Alessia Ferrarini
- Clinica Medica, Department of Internal Medicine, Ospedali Riuniti, Ancona, Italy
| | - Armando Gabrielli
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy,Clinica Medica, Department of Internal Medicine, Ospedali Riuniti, Ancona, Italy
| | - Silvia Svegliati Baroni
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Marco Moretti
- SOD Medicina di Laboratorio, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Riccardo Sarzani
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy,Internal Medicine and Geriatrics, Italian National Research Centre on Aging, Hospital “U. Sestilli”, IRCCS INRCA, via della Montagnola n. 81, 60127, Ancona, Italy
| | - Piero Giordano
- Internal Medicine and Geriatrics, Italian National Research Centre on Aging, Hospital “U. Sestilli”, IRCCS INRCA, via della Montagnola n. 81, 60127, Ancona, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di Ricerca Per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Andrea Corsonello
- Geriatric Medicine, IRCCS INRCA, 87100 Cosenza, Italy,Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, 87100 Cosenza, Italy
| | | | - Antonio Domenico Procopio
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy,Clinical Laboratory and Molecular Diagnostic, Italian National Research Center on Aging, IRCCS INRCA, Ancona, Italy
| | - Manuela Ferracin
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Massimiliano Bonafè
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | | | - Fabiola Olivieri
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy,Center of Clinical Pathology and Innovative Therapy, IRCCS INRCA, Ancona, Italy
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