Hypoglycemia Due to an Insulin-Secreting Small-Cell Carcinoma of the Cervix

Hypoglycemia is a condition commonly seen in the emergency department and is usually caused by insulin or sulfonylurea therapy for diabetes mellitus. Tumor-induced hypoglycemia occurs more rarely and can involve several mechanisms, according to whether the tumor is of pancreatic islet-cell origin or of extrapancreatic, non–islet-cell origin.1 The pancreatic islet beta-cell tumors (insulinomas) cause hypoglycemia by producing excessive insulin. In contrast, non–islet-cell tumors can cause hypoglycemia in any of several ways. They include release by the tumor of insulin-like growth factor II or its high-molecular-weight precursor,2–4 multiple metastases to the liver, massive tumor burden, or rarely, the production of . . .