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A Rare Case of Paraneoplastic Hypoglycemia Induced by Abdominopelvic Gastrointestinal Stromal Tumor

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ARTICLE DOWNLOAD

A Rare Case of Paraneoplastic Hypoglycemia Induced by Abdominopelvic Gastrointestinal Stromal Tumor

10$

Navin Kumar, Sandeep Bhoriwal, Prasenjit Das & S. V. S. Deo 

Purpose

The most common mesenchymal neoplasm (80%) of the gastrointestinal tract is GIST [1, 2]. It accounts for less than 1% of all gastrointestinal malignancies and 5% of all soft tissue sarcoma [1,2,3]. The most common site of GIST is stomach. The more common subtypes of GIST are of spindle cell and epithelioid cell type [1, 4]. GIST arises from interstitial cells of Cajal, which are known as pacemakers of myenteric plexus of the gastrointestinal tract. GIST is diagnosed with histological examination of the tumor tissue sample and more than 95% of tumors are immunostain positive for c-KIT (CD117) [2, 3]. In the present case, tumor tissue was immunostained negative for CD117 and DOG-1, suggestive of wild-type GIST. It is rarely associated with hypoglycemia. Abdominopelvic GIST with hypoglycemia is even rarer. This is usually associated with metastatic or locally advanced high tumor volume disease and is known as NICTH (non-islet cell tumor–associated hypoglycemia) [5]. The main culprit inducer in NICTH is insulin-like growth factor II (IGF-II), apart from IGF-I [5, 6]. Here, we report a case of abdominopelvic GIST with fasting early morning postabsorptive hypoglycemia associated with hypoinsulinemia and decreased insulin-like growth factor I (IGF-I) and C-peptide. The resection of the tumor led to the ablation of hypoglycemic symptoms.

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Year 2020
Language English
Format PDF
DOI 10.1007/s12029-020-00406-y