Non-islet cell tumor hypoglycemia concurrent with acromegalic features: A case report and literature review
BackgroundNon-islet cell tumor hypoglycemia (NICTH) is a rare cause of hypoglycemia due to the overproduction of high molecular weight insulin-like growth factor (big-IGF2), which activates the insulin receptor and subsequently caused hypoglycemia. But NICTH with acromegaly had rarely been reported....
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| Format: | Article |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.968077/full |
| _version_ | 1811209013742796800 |
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| author | Xiaojing Wang Xiaojing Wang Naishi Li Yi Xie Liang Zhu Ji Li Feng Gu Xinhua Xiao |
| author_facet | Xiaojing Wang Xiaojing Wang Naishi Li Yi Xie Liang Zhu Ji Li Feng Gu Xinhua Xiao |
| author_sort | Xiaojing Wang |
| collection | DOAJ |
| description | BackgroundNon-islet cell tumor hypoglycemia (NICTH) is a rare cause of hypoglycemia due to the overproduction of high molecular weight insulin-like growth factor (big-IGF2), which activates the insulin receptor and subsequently caused hypoglycemia. But NICTH with acromegaly had rarely been reported. We firstly reported a rare case of NICTH concurrent with acromegalic facial features induced by a retroperitoneal hemangiopericytoma and reviewed similar cases in the literature.Case presentationA 30-year old man was admitted to hospital because of recurrent unconscious, which usually occurred in the late afternoon or early morning before supper or breakfast. On one unconscious occasion, his blood glucose was 2.4 mmol/L. His consciousness recovered rapidly with intravenous 50% glucose administration. Physical examination showed that he had coarse oily facial features with acne, prominent forehead and brow, broad nose, prominent nasolabial folds. At the time of hypoglycemia, suppressed serum insulin, GH and IGF-1 levels was found. Computed Tomography further revealed a large left retroperitoneal mass measuring 7.0 cm × 12.3 cm × 13.0 cm. He underwent complete surgical resection of the mass. Surgical pathology demonstrated a hemangiopericytoma and strong positive for IGF-2. He did not experience further episodes of hypoglycemia after the operation during the 2.5 years follow-up.ConclusionsFibrous origin is the most common tumor type for NICTH with acromegaly features. NICTH should be considered in non-diabetic patients who have recurrent hypoglycemia along with suppressed serum insulin and IGF-1 levels. |
| first_indexed | 2024-04-12T04:31:31Z |
| format | Article |
| id | doaj.art-a9087c15ecb64385a30754a8b6d9992b |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-12T04:31:31Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-a9087c15ecb64385a30754a8b6d9992b2022-12-22T03:47:55ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-09-01910.3389/fsurg.2022.968077968077Non-islet cell tumor hypoglycemia concurrent with acromegalic features: A case report and literature reviewXiaojing Wang0Xiaojing Wang1Naishi Li2Yi Xie3Liang Zhu4Ji Li5Feng Gu6Xinhua Xiao7Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Endocrinology, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, ChinaDepartment of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Urology Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaBackgroundNon-islet cell tumor hypoglycemia (NICTH) is a rare cause of hypoglycemia due to the overproduction of high molecular weight insulin-like growth factor (big-IGF2), which activates the insulin receptor and subsequently caused hypoglycemia. But NICTH with acromegaly had rarely been reported. We firstly reported a rare case of NICTH concurrent with acromegalic facial features induced by a retroperitoneal hemangiopericytoma and reviewed similar cases in the literature.Case presentationA 30-year old man was admitted to hospital because of recurrent unconscious, which usually occurred in the late afternoon or early morning before supper or breakfast. On one unconscious occasion, his blood glucose was 2.4 mmol/L. His consciousness recovered rapidly with intravenous 50% glucose administration. Physical examination showed that he had coarse oily facial features with acne, prominent forehead and brow, broad nose, prominent nasolabial folds. At the time of hypoglycemia, suppressed serum insulin, GH and IGF-1 levels was found. Computed Tomography further revealed a large left retroperitoneal mass measuring 7.0 cm × 12.3 cm × 13.0 cm. He underwent complete surgical resection of the mass. Surgical pathology demonstrated a hemangiopericytoma and strong positive for IGF-2. He did not experience further episodes of hypoglycemia after the operation during the 2.5 years follow-up.ConclusionsFibrous origin is the most common tumor type for NICTH with acromegaly features. NICTH should be considered in non-diabetic patients who have recurrent hypoglycemia along with suppressed serum insulin and IGF-1 levels.https://www.frontiersin.org/articles/10.3389/fsurg.2022.968077/fullnon-islet cell tumor hypoglycemiaacromegalyIGF-2solitary fibrous tumorhemangiopericytoma |
| spellingShingle | Xiaojing Wang Xiaojing Wang Naishi Li Yi Xie Liang Zhu Ji Li Feng Gu Xinhua Xiao Non-islet cell tumor hypoglycemia concurrent with acromegalic features: A case report and literature review Frontiers in Surgery non-islet cell tumor hypoglycemia acromegaly IGF-2 solitary fibrous tumor hemangiopericytoma |
| title | Non-islet cell tumor hypoglycemia concurrent with acromegalic features: A case report and literature review |
| title_full | Non-islet cell tumor hypoglycemia concurrent with acromegalic features: A case report and literature review |
| title_fullStr | Non-islet cell tumor hypoglycemia concurrent with acromegalic features: A case report and literature review |
| title_full_unstemmed | Non-islet cell tumor hypoglycemia concurrent with acromegalic features: A case report and literature review |
| title_short | Non-islet cell tumor hypoglycemia concurrent with acromegalic features: A case report and literature review |
| title_sort | non islet cell tumor hypoglycemia concurrent with acromegalic features a case report and literature review |
| topic | non-islet cell tumor hypoglycemia acromegaly IGF-2 solitary fibrous tumor hemangiopericytoma |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.968077/full |
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