Hypoglycemia and ventricular tachycardia due to adenocarcinoma of the stomach.

We report the first case of adenocarcinoma of the stomach associated with severe hypoglycemia. Accompanying the profound hypoglycemia, as low as 5 mg per cent by the orthotoluidine method, were multiple episodes of ventricular tachycardia which were abolished by glucose infusion. Following surgical excision of a hemorrhagic portion of the tumor, normoglycemia levels were achieved and ventricular irritability was no longer present. The possible mechanisms of hypoglycemia in extrapancreatic tumors are discussed as well as a mechanism for hypoglycemic-induced ventricular tachycardia. It is postulated that hemorrhage of a necrotic tumor may release large amounts of an insulin-like substance and cause hypoglycemic coma.