Non-islet cell tumor hypoglycemia associated with Gastrointestinal Stromal Tumor: Case report and review of the literature

Vikash Kumar, Dhir Gala, Carson Wonders, Sabrin Marowa, Arnold Forlemu, Vijay Gayam, Madhavi Reddy

Abstract


Non-islet cell tumor hypoglycemia is an uncommon paraneoplastic phenomenon commonly associated with tumors of mesenchymal origin like gastrointestinal stromal tumors (GIST). It causes the release of insulin-like growth factor type II. GIST are frequently asymptomatic but can present with vague symptoms such as gastrointestinal bleeding, gastric pain, anorexia, nausea, and vomiting. We present an interesting case of A 62-year-old male with GIST tumor admitted for refractory hypoglycemia found to have non-islet cell tumor hypoglycemia which is a relatively uncommon cause of hypoglycemia.


Keywords


Non-islet cell tumor hypoglycemia; GIST; insulin-like growth factor-II

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References


Wilson JM, Ginsberg J, Cutts K, Urban S. A Case of Non-Islet Cell Tumor Hypoglycemia (NICTH) Associated with Gastrointestinal Stromal Tumor (GIST). Am J Case Rep. 2017;18:984-988. doi: 10.12659/ajcr.904753. PMID: 28900071; PMCID: PMC5608149.

Eghbali F, Karami R. Refractory hypoglycemia induced by a duodenal wall gastrointestinal stromal tumor: A case report. Casp J Int Med. 2021;12(Suppl 2):S447-S450. DOI: 10.22088/cjim.12.0.447. PMID: 34760103; PMCID: PMC8559628.

Menge F, Jakob J, Kasper B, et al. Clinical Presentation of Gastrointestinal Stromal Tumors. Visc Med. 2018;34(5):335-340. doi: 10.1159/000494303. PMID: 30498699; PMCID: PMC6257088.

Sharma NR, Gopakumar H, Harrison S, Ehmke N, Zelt C. Gastric Gastrointestinal Stromal Tumors (GIST): a Case Series and Current State of the Art in the Workup and Treatment of This Rare Disease. J Gastrointest Cancer. 2019;50(3):548-555. doi: 10.1007/s12029-017-0034-7. PMID: 29192406.

De Vogelaere K, Aerts M, Haentjens P, De Grève J, Delvaux G. Gastrointestinal stromal tumor of the stomach: progresses in diagnosis and treatment. Acta Gastroenterol Belg. 2013;76(4):403-6. PMID: 24592543.

Kim KM, Kang DW, Moon WS, et al. Gastrointestinal Stromal Tumors in Koreans: It's Incidence and the Clinical, Pathologic and Immunohistochemical Findings. J Korean Med Sci. 2005;20(6):977-984. https://doi.org/10.3346/jkms.2005.20.6.977

Escobar GA, Robinson WA, Nydam TL, et al. Severe paraneoplastic hypoglycemia in a patient with a gastrointestinal stromal tumor with an exon 9 mutation: a case report. BMC Cancer. 2007;7:13. doi: 10.1186/1471-2407-7-13. PMID: 17229322; PMCID: PMC1781460.

Saeed Z, Taleb S, Evans-Molina C. A case of extragastrointestinal stromal tumor complicated by severe hypoglycemia: a unique presentation of a rare tumor. BMC Cancer. 2016;16:930. https://doi.org/10.1186/s12885-016-2968-8

Shapiro ET, Bell GI, Polonsky KS, et al. Tumor hypoglycemia: relationship to high molecular weight insulin-like growth factor-II. J Clin Invest. 1990;85(5):1672-1679. doi: 10.1172/JCI114619. PMID: 2159026; PMCID: PMC296620.

Caliri M, Verdiani V, Mannucci E, et al. A case of malignant insulinoma responsive to somatostatin analogs treatment. BMC Endocr Disord. 2018;18(1):98. doi: 10.1186/s12902-018-0325-4. PMID: 30591061; PMCID: PMC6307122.

Bodnar TW, Acevedo MJ, Pietropaolo M. Management of non-islet-cell tumor hypoglycemia: a clinical review. J Clin Endocrinol Metab. 2014;99(3):713-22. doi: 10.1210/jc.2013-3382. PMID: 24423303; PMCID: PMC5393479.

Fukuda I, Hizuka N, Ishikawa Y, et al. Clinical features of insulin-like growth factor-II producing non-islet-cell tumor hypoglycemia. Growth Horm IGF Res. 2006;16(4):211-216. doi: 10.1016/j.ghir.2006.05.003. PMID: 16860583.

de Silva CM, Reid R. Gastrointestinal stromal tumors (GIST): C-kit mutations, CD117 expression, differential diagnosis and targeted cancer therapy with Imatinib. Pathol Oncol Res. 2003;9(1):13-19. doi: 10.1007/BF03033708. PMID: 12704441.

Guiteau J, Fanucchi M, Folpe A, Staley CA 3rd, Kooby DA. Hypoglycemia in the setting of advanced gastrointestinal stromal tumor. Am Surg. 2006;72(12):1225-1230. doi: 10.1177/000313480607201216. PMID: 17216825.

Baird K, Davis S, Antonescu CR, et al. Gene expression profiling of human sarcomas: insights into sarcoma biology. Cancer Res. 2005;65(20):9226-35. doi: 10.1158/0008-5472.CAN-05-1699. PMID: 16230383.

Kanzaki M, Kashihara H, Kiura K, et al. Severe hypoglycemia induced by IGF-II producing non-islet cell tumor. Intern Med. 2007;46(13):1061. doi: 10.2169/internalmedicine.46.6455. PMID: 17603253.

Sullivan DH, Carter WJ, Warr WR, Williams LH. Side effects resulting from the use of growth hormone and insulin-like growth factor-I as combined therapy to frail elderly patients. J Gerontol A Biol Sci Med Sci. 1998;53(3):M183-7. doi: 10.1093/gerona/53a.3.m183. PMID: 9597049.

Baxter RC, Holman SR, Corbould A, et al. Regulation of the insulin-like growth factors and their binding proteins by glucocorticoid and growth hormone in nonislet cell tumor hypoglycemia. J Clin Endocrinol Metab. 1995;80(9):2700-2708. doi: 10.1210/jcem.80.9.7545698. PMID: 7545698.




DOI: http://dx.doi.org/10.22551/2023.38.1001.10240

Copyright (c) 2023 Vikash Kumar, Dhir Gala, Carson Wonders, Sabrin Marowa, Arnold Forlemu, Vijay Gayam, Madhavi Reddy

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ISSN: 2360-6975