Hyperglycemia Associated with IL-6 Producing Renal Cell Carcinoma

Abstract

A 59-year-old male with a 2-year history of diabetes mellitus and a half-year history of hematuria, night sweats, and back pain was admitted for glycemic control and to evaluate bilateral renal tumors.Laboratory data showed rising inflammatory markers and increased HbA_ic of 7.9%. Glycemic control required 37 units of insulin daily preoperatively for the renal tumors, but no medication was required for glycemic control postoperatively.Preoperative plasma interleukin (IL)-6 was 21.2pg/ml and a histological evaluation confirmed IL-6 expression by some of the renal cell carcinomas.Six months later, when glycemic control was satisfactory and plasma IL-6 was normal, a metastatic lesion was noted in the lung and excised.Histological examination showed no IL-6 expression in this metastatic lesion.One year later, however, further lung metastasis was found and glycemic control worsened gradually accompanied by increasing plasma IL-6 along with the expansion and dissemination of lung metastasis.This is, to our knowledge, the first case report demonstrating the possible association of glycemic control and IL-6 production by the tumor cells in renal cell carcinoma.