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Case Reports in Endocrinology
Volume 2013, Article ID 308086, 3 pages
Case Report

Nonislet Cell Tumor Hypoglycemia

Department of Endocrinology, Diabetes & Metabolism, Nassau University Medical Center, East Meadow, NY 11554, USA

Received 14 June 2013; Accepted 2 September 2013

Academic Editors: G. Aimaretti, J. P. Frindik, K. Iida, O. Isozaki, L. Mastrandrea, and T. Nagase

Copyright © 2013 Johnson Thomas and Salini C. Kumar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Nonislet cell tumor hypoglycemia (NICTH) is a rare cause of hypoglycemia. It is characterized by increased glucose utilization by tissues mediated by a tumor resulting in hypoglycemia. NICTH is usually seen in large mesenchymal tumors including tumors involving the GI tract. Here we will discuss a case, its pathophysiology, and recent advances in the management of NICTH. Our patient was diagnosed with poorly differentiated squamous cell carcinoma of esophagus. He continued to be hypoglycemic even after starting continuous tube feeds and D5W. General workup for hypoglycemia was negative and insulin-like growth factor II (IGF II) was in the normal range. Hypoglycemia secondary to “big” IGF II was considered, and patient was started on steroids. His hypoglycemia resolved within a day of treatment with steroids. Initially patient had hypoglycemia unawareness, which he regained after maintaining euglycemia for 48 hours.