Non-islet cell tumor hypoglycemia (NICTH) is a rare association between spontaneous hypoglycemia and tumors derived from tissues other than the pancreatic islets. It was initially associated with abdominal soft tissue sarcomas, although other tumor types have been described.
The pathogenesis of hypoglycemia in NICTH may involve a variety of mechanisms, including excessive consumption of glucose by what is typically a large tumor; inadequate production of counterregulatory hormones, such as growth hormone or cortisol; or ectopic or abnormal secretion of insulin or insulin-like growth factor-2 (IGF-II) and IGF-binding proteins. This last mechanism seems to be the most frequent and best characterized in patients with typical NICTH. Insulin secretion by the non-beta-cell tumor is, however, extremely rare and most cases published are secondary to secretion of an incompletely processed IGF-II by the tumor (big IGF-II), which acts as an insulin-like factor in the insulin receptors, causing hypoglycemia
A research team led by Dr. Robert Diaz and his team from Spain have written an article to be published on March 28, 2008 in the World Journal of Gastroenterology. A 74-year-old patient with advanced sigmoid cancer, who suffered recurrent bouts of fasting hypoglycemia presented to them. The diagnostic work-up finally revealed the ectopic production of insulin by the tumor. The possible simultaneous presence of a pancreatic insulin-secreting primary tumor (insulinoma) was ruled out by different laboratory and imaging tests.
|Contact: Jing Zhu|
World Journal of Gastroenterology