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Case Reports
. 2019 May 15;11(5):e4669.
doi: 10.7759/cureus.4669.

Non-islet Cell Tumor-induced Hypoinsulinemic Hypoglycemia in the Setting of Metastatic Desmoplastic Round Cell Tumor

Nadir Bhuiyan  1 , Purva Sharma  1
Affiliations
Case Reports

Non-islet Cell Tumor-induced Hypoinsulinemic Hypoglycemia in the Setting of Metastatic Desmoplastic Round Cell Tumor

Nadir Bhuiyan et al. Cureus. .

Abstract

A 24-year-old male with metastatic desmoplastic round cell tumor was admitted for fatigue and weakness after chemotherapy. The patient was found to be hypotensive, pancytopenic, and bacteremic. Early treatment with intravenous antibiotics and fluids was efficacious. The hospital course was complicated by recurrent hypoglycemia that was refractory to the standard hypoglycemia protocol. Initial workup revealed low serum insulin and normal C-peptide. Further evaluation revealed elevated IGF-II levels consistent with non-islet cell tumor-induced hypoglycemia. Euglycemia was subsequently achieved with aggressive and continuous infusion of intravenous 10% dextrose.

Keywords: desmoplastic round cell tumor; non-islet cell tumor induced hypoglycemia; paraneoplastic syndrome; tumor induced hypoglycemia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Axial CT scan of the abdomen with intravenous contrast demonstrating innumerable liver metastases.
*Arrows demonstrating significant metastatic tumor burden in the liver with massive hepatomegaly.
See this image and copyright information in PMC

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References

    1. Management of endocrine disease: a clinical update on tumor-induced hypoglycemia. Iglesias P, Díez JJ. Eur J Endocrinol. 2014;170:147–157. - PubMed
    1. Symptomatic hypoglycemia related to inappropriately high IGF-II serum levels in a patient with desmoplastic small round cell tumor. [May;2019 ];Barra WF, Castro G, Hoff AO, Siqueira SA, Hoff PM. https://www.hindawi.com/journals/crim/2010/684045/ Case Rep Med. 2010 2010:3. - PMC - PubMed
    1. Can "big" insulin-like growth factor II in serum of tumor patients account for the development of extrapancreatic tumor hypoglycemia? Zapf J, Futo E, Peter M, Froesch ER. J Clin Invest. 1992;90:2574–2584. - PMC - PubMed
    1. Landmarks in insulin research. Ward CW, Lawrence MC. Front Endocrinol (Lausanne) 2011;2:76. - PMC - PubMed
    1. Refractory hypoglycemia in a pediatric patient with desmoplastic small round cell tumor. Almaghraby A, Brickman WJ, Goldstein JA, Habiby RL. J Pediatr Endocrinol Metab. 2018;31:947–950. - PubMed

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