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

Abstract 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...

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Main Authors: 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
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Endocrine Disorders
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Online Access:https://doi.org/10.1186/s12902-025-01885-5
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author 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
author_facet 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
author_sort Atefeh Jannatalipour
collection DOAJ
description Abstract 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.
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issn 1472-6823
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publishDate 2025-03-01
publisher BMC
record_format Article
series BMC Endocrine Disorders
spelling doaj-art-a0bb23c1ff02453a87a49b905138bfcb2025-08-20T02:47:06ZengBMCBMC Endocrine Disorders1472-68232025-03-012511510.1186/s12902-025-01885-5Non-islet cell tumor hypoglycemia (NICTH) associated with sarcoma, case reportAtefeh Jannatalipour0Nekoo Panahi1Mahnaz Pejman Sani2Omid Ghaemi3Maryam Kheirandish4Neda Alipour5Azadeh Zarinkolah6Mostafa Jawhari7Bahman Rasuli8Mohammad Reza Mohajeri-Tehrani9Hamid Reza Aghaei Meybodi10Akbar Soltani11Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical SciencesMetabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical SciencesEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical SciencesDepartment of Radiology and Interventional Radiology, Imam Khomeini Hospital (Imaging Centre) and Shariati Hospital, Tehran University of Medical SciencesEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical SciencesEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical SciencesEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical SciencesDepartment of Radiology and Interventional Radiology, Imam Khomeini Hospital (Imaging Centre, Tehran University of Medical SciencesDepartment of Radiology and Interventional Radiology, Imam Khomeini Hospital (Imaging Centre, Tehran University of Medical SciencesEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical SciencesEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical SciencesEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical SciencesAbstract 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.https://doi.org/10.1186/s12902-025-01885-5Case reportHypoglycemiaNon-islet cellRecombinant growth hormoneAngioembolization
spellingShingle 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
Non-islet cell tumor hypoglycemia (NICTH) associated with sarcoma, case report
BMC Endocrine Disorders
Case report
Hypoglycemia
Non-islet cell
Recombinant growth hormone
Angioembolization
title Non-islet cell tumor hypoglycemia (NICTH) associated with sarcoma, case report
title_full Non-islet cell tumor hypoglycemia (NICTH) associated with sarcoma, case report
title_fullStr Non-islet cell tumor hypoglycemia (NICTH) associated with sarcoma, case report
title_full_unstemmed Non-islet cell tumor hypoglycemia (NICTH) associated with sarcoma, case report
title_short Non-islet cell tumor hypoglycemia (NICTH) associated with sarcoma, case report
title_sort non islet cell tumor hypoglycemia nicth associated with sarcoma case report
topic Case report
Hypoglycemia
Non-islet cell
Recombinant growth hormone
Angioembolization
url https://doi.org/10.1186/s12902-025-01885-5
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