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KMID : 0356620100250020125
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Journal of Korean Society of Endocrinology
2010 Volume.25 No. 2 p.125 ~ p.130
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A Case of Gastrointestinal Stromal Tumor with Recurrent Hypoglycemia
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Ko Sun-Hee
Kim Seok-Hwan
Maeng Il-Ho
Kim Koon-Soon
Jang Yi-Sun
Kim Hye-Soo
Lee Jong-Min
Park Suk-Young
Kang Sang-Bum
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Abstract
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Non-islet cell tumor induced hypoglycemia (NICTH) is attributable to overproduction of insulin-like growth factor-II (IGF-II) by solid tumors, and these tumors usually originate from mesenchymal or epithelial cells. Gastrointestinal stromal tumor (GIST) is arare mesenchymal tumor and most commonly find in the gastrointestinal tract. It is usually expresses the CD117 (stem cell factor receptor, c-kit) detected by immunohistochemistry. Hypoglycemia associated with GIST is very rare and this has not yet been reported in Korea. A 72-year-old man was hospitalized due to frequent episodes of confusion. It was observed that non-hyperinsulinemic hypoglycemia, an elevated serum IGF-II level and a huge liver mass. The histology of liver mass showed c-kit (CD117) positivity, which was consistent with GIST, but it was surgically unresectable. He was treated with imatinib mesylate. Although he recieved palliative treatment, he still experienced intermittent fasting hypoglycemia. After 2 months, the serum IGF-II level was even higher than before. We changed imatinib mesylate to sunitinib malate and performed radiotherapy on the liver mass. Although the change of the liver mass was not significant, he did not suffer from hypoglycemia for three months afterwards.
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KEYWORD
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Gastrointestinal stromal tumor (GIST), Insulin-like growth factor-II (IGF-II), Non-islet cell tumor induced hypoglycemia
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