Non-islet cell tumor hypoglycemia (NICTH) as a rare paraneoplastic syndrome in high-grade serous ovarian carcinoma: A case report and review of the literature
Year: 2025
Type: article
Study design: Case Report
Abstract: • This is the first reported case of non-islet cell tumor hypoglycemia (NICTH) presenting as the manifestation of high-grade serous ovarian cancer, both at initial diagnosis and at recurrence. • The severe hypoglycemia resulted from tumor-related secretion of high molecular weight IGF-II. • This rare paraneoplastic syndrome was associated with poor prognosis. Non–islet cell tumor hypoglycemia (NICTH) is a rare paraneoplastic syndrome caused by excessive secretion of incompletely processed insulin–like growth factor–2 (IGF–2) from tumor cells. This leads to severe, refractory hypoglycemia. A 67–year–old woman presented with stage IIIC high-grade ovarian carcinoma associated with severe hypoglycemia at diagnosis, and at recurrence. Laboratory tests showed suppressed insulin and C–peptide levels, with an elevated IGF–2/IGF–1 ratio, consistent with NICTH. The patient underwent primary surgery followed by adjuvant platinum-based chemotherapy and maintenance therapy with bevacizumab and olaparib. This comprehensive treatment approach led to remission of both the carcinoma and the associated severe paraneoplastic hypoglycemia. The relapse of the disease was accompanied by a recurrence of hypoglycemia, refractory to medical treatement, which ultimately led to the patient’s death. This represents the first reported case of HGSOC with NICTH, emphasizing the complexity of ovarian cancer presentations and the importance of early diagnosis and comprehensive management in rare paraneoplastic conditions.
Source: Gynecologic Oncology Reports
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $930
OpenAlex ID: W4415197831