Intracranial malignant meningioma with abdominal metastases associated with hypoglycemic shock: a case report

A thirty-year-old male with an intracranial malignant meningioma, first dia gnosed 9 years ago, with three recurrences was admitted with a hypoglycemic shock. The blood glucose level was 17 mg/dl, requiring treatment with high doses of intravenous and oral dextrose for improvement. A large metastatic tumor in the liver was noted. All hormones and peptides influencing blood glucose levels were in their normal levels. Chemo-embolization and injectio n of anti-cancer drugs was employed in the management of the metastatic tum or. Positron emission tomography was performed to measure the glucose metab olism of the abdominal tumor and it indicated that glucose consumption with in the tumor was much elevated than the surrounding abdominal organs. Hypog lycemia secondary to primary hepatoma or islet-cell cancer has been frequen tly described, but a complication of metastatic meningioma is an exceedingl y rare event. Elevated glucose consumption within the tumor might be addres sed as one of the reasons for hypoglycemia, not due to the elevated serum l evels of insulin or IGF, but due to the closely related blood glucose level .