The first report of primary carcinoma of the liver associated with hypoglycemia was a case described by Nadler and Wolfer, in 1929.1 The authors considered that the hypoglycemia could have resulted at least in part from a quantitative loss of liver substance, but they were disturbed by the absence of symptoms suggestive of hepatic insufficiency. Relatively little has been added to clarify this problem since the initial publication. This can be partially explained by the paucity of reports of hypoglycemia associated with hepatoma. Although primary carcinoma of the liver is an uncommon tumor in this country, it is, nevertheless, estimated to occur in 0.47% of autopsied cases.2 However, there have been only five reports relating this tumor to hypoglycemia.1,3-6 It is of interest that no mention is made of hepatoma as a cause of hypoglycemia in the extensive review of the causes of hypoglycemia by Conn* and
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