Transarterial chemoembolization for palliation of paraneoplastic hypoglycemia in a patient with advanced hepatocellular carcinoma

摘要

Hypoglycemia caused by paraneoplastic secretion of insulin-like growth factors (IGFs) is a rare complication could have increased the risk of mycotic aneurysm, as previously reported (3); however, no organisms were cultured in blood or thrombus. Severe rheumatoid disease can cause aortitis, but no periaortic inflammation was seen in the present case (Fig 1).Spontaneous aortoenteric fistula is less common, and reported only in the presence of infection. When there is communication between the aorta and part of the gastrointestinal tract, ectopic gas adjacent to or within the aorta is the predominant CT finding (4). Degenerative disease of the lumbar intervertebral discs may exhibit gas within the degenerate disc. Perhaps the intervertebral gas diffused into the aneurysm sac; however, we are unaware of any reported cases of spontaneous aneurysm sac gas associated with this condition. In conclusion, the present report suggests that aortic sac gas can be a benign finding, independent of aortic infection or aortoenteric fistula.