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JAMA. 1961;178(3):323. doi:10.1001/jama.1961.03040420063016.
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Considerable clinical evidence has accumulated in recent years that some large nonpancreatic tumors cause, or are associated with, severe hypoglycemia. Although such cases are being reported more frequently the literature does not clarify this phenomenon. Doege reported the first case in 1930; since then 27 additional cases2 have been reported. While these tumors are similar histologically, various names, such as fibrogenic, fibrosarcoma, neurofibrosarcoma, fibrous mesothelioma, and spindle cell sarcoma have been assigned. Each has been a large malignant tumor, located usually in the retroperitoneal region or in the thorax. Some were present for years before hypoglycemia developed, causing unconscious spells, convulsions, profuse sweating, coarse tremors, weakness, blurred vision, and other signs of severe hypoglycemia. The blood sugar level has been reported as low as 9 mg. %.4 The observers agreed that the hypoglycemia was not caused by pituitary, adrenal, or hepatic insufficiency, nor to islet cell tumors of the


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