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<p>Non-islet cell tumor hypoglycemia (NICTH) is a rare paraneoplastic syndrome caused by the secretion of high molecular weight insulin-like growth factor II (IGF-II) from tumors, particularly those of mesenchymal and epithelial origin. This case report describes a 71-year-old male with pelvic sarcoma who presented with severe hypoglycemia, with blood glucose levels dropping below 40&#xa0;mg/dL and exhibiting neuroglycopenic symptoms. The diagnosis of NICTH was confirmed through biochemical analysis showing hypoinsulinemic hypoglycemia alongside low C-peptide and IGF-1 levels. Initial management with dextrose infusions and glucocorticoids proved ineffective until recombinant human growth hormone (rhGH) therapy was initiated, resulting in a decreased requirement for dextrose. Following angioembolization of the tumor, the patient’s blood glucose levels stabilized sufficiently to allow for the complete cessation of dextrose administration. This case highlights the critical role of rhGH in reducing dextrose dependency and the effectiveness of angioembolization in managing NICTH when surgical options are limited.</p>

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Non-islet cell tumor hypoglycemia (NICTH) associated with sarcoma, case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月5日

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  • Atefeh Jannatalipour,
  • Nekoo Panahi,
  • Mahnaz Pejman Sani,
  • Omid Ghaemi,
  • Maryam Kheirandish,
  • Neda Alipour,
  • Azadeh Zarinkolah,
  • Mostafa Jawhari,
  • Bahman Rasuli,
  • Mohammad Reza Mohajeri-Tehrani,
  • Hamid Reza Aghaei Meybodi,
  • Akbar Soltani

摘要

Non-islet cell tumor hypoglycemia (NICTH) is a rare paraneoplastic syndrome caused by the secretion of high molecular weight insulin-like growth factor II (IGF-II) from tumors, particularly those of mesenchymal and epithelial origin. This case report describes a 71-year-old male with pelvic sarcoma who presented with severe hypoglycemia, with blood glucose levels dropping below 40 mg/dL and exhibiting neuroglycopenic symptoms. The diagnosis of NICTH was confirmed through biochemical analysis showing hypoinsulinemic hypoglycemia alongside low C-peptide and IGF-1 levels. Initial management with dextrose infusions and glucocorticoids proved ineffective until recombinant human growth hormone (rhGH) therapy was initiated, resulting in a decreased requirement for dextrose. Following angioembolization of the tumor, the patient’s blood glucose levels stabilized sufficiently to allow for the complete cessation of dextrose administration. This case highlights the critical role of rhGH in reducing dextrose dependency and the effectiveness of angioembolization in managing NICTH when surgical options are limited.