Remarkable body weight gain in a patient in the terminal phase of gastric carcinoma secondary to ‘big IGF-II’- producing tumor

Introduction: Weight loss as a result of cachexia with malignancy is frequently encountered in clinical practice. However, previous reports have not demonstrated weight gain in terminal phase of malignancy. Case Report: We report a 69­year­old male admitted with an exacerbation of interstitial pneumonia and multiple metastases of relapsed gastric adenocarcinoma complicated with refractory hypoglycemia. He had gained approximately 10 kg weight with an acromegaloid appearance in a one­month period before admission. The presence of big insulin­like growth fact II (Big IGF­II) in his blood and an immunohistochemical study on the tumor cells confirmed a diagnosis of non­ islet cell tumor hypoglycemia. Conclusion: This report possibly illustrates an unreported differential diagnosis of weight gain in terminal phase of malignancy.