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Non-islet cell tumor hypoglycemia (NICTH) associated with sarcoma, case report
Atefeh Jannatalipour1,2, Nekoo Panahi3,4, Mahnaz Pejman Sani5,6
1Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
BMC Endocrine Disorders
|March 5, 2025
Summary
Non-islet cell tumor hypoglycemia (NICTH) is a rare condition. This case study shows recombinant human growth hormone (rhGH) and angioembolization effectively managed severe hypoglycemia in a patient with pelvic sarcoma.
Area of Science:
- Endocrinology
- Oncology
- Metabolic Syndromes
Background:
- Non-islet cell tumor hypoglycemia (NICTH) is a rare paraneoplastic syndrome.
- It is characterized by excessive secretion of high molecular weight insulin-like growth factor II (IGF-II) by tumors.
- Tumors of mesenchymal and epithelial origin are commonly implicated.
Purpose of the Study:
- To report a case of NICTH in a patient with pelvic sarcoma.
- To evaluate management strategies for severe hypoglycemia in NICTH.
- To highlight the role of recombinant human growth hormone (rhGH) and angioembolization.
Main Methods:
- A 71-year-old male with pelvic sarcoma presented with severe hypoglycemia and neuroglycopenic symptoms.
- Diagnosis was confirmed via biochemical analysis showing hypoinsulinemic hypoglycemia with low C-peptide and IGF-1.
- Treatment involved dextrose infusions, glucocorticoids, rhGH therapy, and angioembolization.
Main Results:
- Initial management with dextrose and glucocorticoids was insufficient.
- Recombinant human growth hormone (rhGH) therapy reduced dextrose requirements.
- Angioembolization of the tumor led to blood glucose stabilization and cessation of dextrose.
Conclusions:
- Recombinant human growth hormone (rhGH) is crucial in reducing dextrose dependency in NICTH.
- Angioembolization is an effective treatment for NICTH, especially when surgery is not feasible.
- This case underscores a multimodal approach for managing complex NICTH cases.
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