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Non-islet Cell Tumor-related Hypoglycemia in a Case of Metastatic Gastrointestinal Stromal Tumor: A Rare Paraneoplastic Syndrome: A Case Report

Year: 2022

Type: article

Abstract: Case Report IntroductIonGastrointestinal stromal tumor (GIST) is the most common type of mesenchymal tumor of the gastrointestinal (GI) tract.Usual presentations include intestinal obstruction, bleeding, and perforation.Rare presentations are paraneoplastic symptoms such as hyperpigmentation, mastocytosis, and hypoglycemia.[1] Hypoglycemia is rarely observed in GIST, known as nonislet cell tumor-related hypoglycemia (NICTH).NICTH mimics insulinoma, and diagnosis is suspected in the presence of a bulky or metastatic tumor, biochemical evidence of low insulin, C-peptide, and elevated insulin-like growth factor-2 (IGF-2).[2] The goals of the treatment include management of hypoglycemia and modalities to decrease the tumor burden.There are only 10 case reports in the literature on NICTH in GIST [Table 1].We present a rare case of metastatic GIST, where the patient presented with hypoglycemic episodes and was managed with Imatinib. case rePortA 46-year-old female presented with complaints of diffuse abdominal pain for 2 months, which was insidious in onset, mild, and dull aching associated with abdominal distention and constipation.She had no nausea, vomiting, jaundice, GI bleeding, anorexia, or weight loss.History of seizure, bone pain, or respiratory distress was absent.She had intermittent episodes of syncope, which used to improve after food intake.Examination revealed multiple, nontender, firm, mobile lumps over the abdomen.Rectal examination, per-vaginal examination, and other systemic examinations were within normal limits.Abdominal sonography and contrast-enhanced computed tomography revealed multiple heterogeneously enhancing lesions in the peritoneal cavity, mild ascites, and subcentimetric lymph nodes in the external iliac, obturator, and common iliac region [Figure 1].Percutaneous biopsy and

Source: Apollo Medicine

DOI: 10.4103/am.am_67_22

Authors: Nalini Kanta Ghosh, Ashok Kumar, Vijay Kumar Sharma, Vikrant Verma

Institution: Sanjay Gandhi Post Graduate Institute of Medical Sciences

Language: English

Topic: Gastrointestinal Tumor Research and Treatment

Subfield: Gastroenterology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4312870410