{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:23:16Z","timestamp":1787016196170,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,7,6]],"date-time":"2019-07-06T00:00:00Z","timestamp":1562371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Veterinary Clinical Pathol"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A 13\u2010year\u2010old spayed female Pomeranian dog was presented for persistent, severe hypoglycemia (37\u00a0mg\/dL; reference interval [RI] 75\u2010128\u00a0mg\/dL). Progressive nonregenerative anemia (hematocrit 23.3%\u201015.9%; RI 37.0%\u201055.0%) and severe thrombocytopenia (36\u00a0000\/\u00b5L; RI 200\u2010500\u00a0000\/\u00b5L) were also noted. The serum insulin concentration was low (0.24\u00a0ng\/mL; RI 0.302\u20101.277\u00a0ng\/mL). Computed tomography revealed multiple splenic nodules (1\u20106\u00a0mm in diameter) and several hepatic nodules (7.6, 12\u00a0mm in diameter). Ultrasound\u2010guided fine\u2010needle aspiration of the splenic and hepatic nodules revealed low numbers of epithelial cells with mild cellular atypia, suggestive of a metastatic epithelial tumor, but the primary site was unknown at that time. On careful oral examination under general anesthesia, an enlarged right tonsil was noted grossly, and histopathologic examination of the tonsil diagnosed squamous cell carcinoma. Bone marrow aspirates and biopsies of the splenic and hepatic nodules were performed; all samples were diagnosed as metastatic carcinoma on histopathologic examination. No nodules were present in the pancreas, despite careful palpation during exploratory laparotomy. On immunohistochemistry, the neoplastic cells were positive for cytokeratin AE1\/3 and insulin\u2010like growth factor (IGF)\u2010I but were negative for chromogranin A, PGP9.5, insulin, and inconclusive for IGF\u2010II. This is the first report of a primary IGF\u2010I\u2010producing squamous cell carcinoma in the tonsil of a dog with metastases to bone marrow, liver, and spleen, resulting in hypoglycemia.<\/jats:p>","DOI":"10.1111\/vcp.12753","type":"journal-article","created":{"date-parts":[[2019,7,6]],"date-time":"2019-07-06T20:54:34Z","timestamp":1562446474000},"page":"429-434","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hypoglycemia associated with disseminated metastatic tonsillar squamous cell carcinoma producing insulin\u2010like growth factor\u2010I in a Pomeranian dog"],"prefix":"10.1111","volume":"48","author":[{"given":"Kazushi","family":"Azuma","sequence":"first","affiliation":[{"name":"Synergy Animal General Hospital Kawaguchi\u2010shi Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Asakawa","sequence":"additional","affiliation":[{"name":"Synergy Animal General Hospital Kawaguchi\u2010shi Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Konno","sequence":"additional","affiliation":[{"name":"Synergy Animal General Hospital Kawaguchi\u2010shi Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoko","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Synergy Animal General Hospital Kawaguchi\u2010shi Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midori","family":"Goto Asakawa","sequence":"additional","affiliation":[{"name":"Synergy Animal General Hospital Kawaguchi\u2010shi Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,6]]},"reference":[{"key":"e_1_2_4_2_1","first-page":"246","volume-title":"Textbook of Veterinary Internal Medicine","author":"Forcada Y","year":"2017"},{"key":"e_1_2_4_3_1","first-page":"707","volume-title":"Fundamentals of Veterinary Clinical Pathology","author":"Stockham SL","year":"2008"},{"key":"e_1_2_4_4_1","first-page":"577","article-title":"Pancreatic insulin\u2010secreting neoplasms: clinical, diagnostic, and prognostic features in 73 dogs","volume":"24","author":"Caywood DD","year":"1988","journal-title":"J Am Anim Hosp Assoc"},{"key":"e_1_2_4_5_1","unstructured":"BoariA VenturoliM MinutoF.Non\u2010islet cell tumor hypoglycemia in a dog associated with high levels of insulin\u2010like growth factor II. 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