13 September 2017
: Case report
A Case of Non-Islet Cell Tumor Hypoglycemia (NICTH) Associated with Gastrointestinal Stromal Tumor (GIST)
Rare disease
John M Wilson1AE*, Jessica Ginsberg1AEF, Karen Cutts2E, Steve Urban2EDOI: 10.12659/AJCR.904753
Am J Case Rep 2017; 18:984-988
Abstract
BACKGROUND: Non-islet cell tumor hypoglycemia (NICTH) is a newly recognized, but uncommon, paraneoplastic syndrome that is associated with tumors of mesenchymal origin. We report a case of NICTH associated with a gastrointestinal stromal tumor (GIST).
CASE REPORT: A 60-year-old man presented to the emergency department of our hospital after being found unconscious in his home. His serum blood glucose on hospital admission was 40 mg/dL. He reported a three-month history of diffuse abdominal pain, fatigue, and blurred vision. Laboratory medicine investigations showed reduced levels of insulin, C-peptide, insulin-like growth factor binding protein (IGFBP)-3, and insulin-like growth factor (IGF)-1, but his IGFBP-2 was increased. Computed tomography (CT) scan of the chest and abdomen showed an abdominal mass that involved the small bowel, mesentery, and omentum, with lesions in the right lung and the left rib. Histopathology of a CT-guided biopsy of the abdominal mass showed a low-grade sarcomatous spindle cell neoplasm that was positive for CD117 using immunohistochemistry and with an exon 11 c-KIT mutation. These findings were consistent with a diagnosis of GIST and treatment with imatinib commenced.
CONCLUSIONS: This case report has shown that hypoglycemia in the setting of low levels of insulin, C-peptide, IGF-1, and IGFBP-3 is suggestive of a diagnosis of NICTH, which should be investigated for an underlying source, which in this case, was confirmed to be a malignant GIST.
Keywords: gastrointestinal stromal tumors, Hypoglycemia, Paraneoplastic Syndromes, Proto-Oncogene Proteins c-kit
SARS-CoV-2/COVID-19
31 January 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.937955
18 January 2023 : Case report
Am J Case Rep 2023; 24:e938667
30 December 2022 : Case report
Am J Case Rep 2022; 23:e938571
22 December 2022 : Case report
Am J Case Rep 2022; 23:e938003
In Press
01 Feb 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.938498
31 Jan 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.937955
31 Jan 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.938889
27 Jan 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.938548
Most Viewed Current Articles
13 Jul 2022 : Case report
DOI :10.12659/AJCR.936441
Am J Case Rep 2022; 23:e936441
06 Dec 2021 : Case report
DOI :10.12659/AJCR.934406
Am J Case Rep 2021; 22:e934406
23 Feb 2022 : Case report
DOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250
17 Feb 2022 : Case report
DOI :10.12659/AJCR.934399
Am J Case Rep 2022; 23:e934399