Non-islet cell tumour hypoglycaemia

Krishnan, Leena; Clark, John D.

doi:10.1136/bcr.02.2011.3914

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…Serum levels of IGFBP-2 also had a tendency to decrease toward normal levels, and serum ALS concentrations increase significantly. [ 65 ] At the same time, insulin and C-peptide in the serum increased. Tsuro et al reviewed 20 Japanese cases of IGF-II-producing tumors, in which 5 of 6 cases were treated with glucocorticoid therapy and as a consequence, no longer suffered from hypoglycemic attacks in spite of receiving no antitumor therapy.…”

Section: Treatmentmentioning

confidence: 99%

Doege–Potter syndrome

Han¹,

Zhang²,

Xing-bin³

et al. 2017

Medicine

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Rationale:We reviewed 76 published cases of Doege–Potter syndrome, and non-islet cell tumor hypoglycemia (NICTH) secondary to a solitary fibrous tumor (SFT) between 1989 and 2016, to study disease pathogenesis, diagnosis, and treatment of this rare paraneoplastic disease. Further, we report 1 new case of a patient presenting with Doege–Potter syndrome.Patients concerns:The tumors originated from the pleural cavity, lung, pelvis, liver, retroperitoneum, kidney, mediastinal, the sella, uterus, bladder, intestine, mandibular, and the thigh. The most common location was the pleural cavity (left 12 cases and right 28 cases). Moreover, 28/71 (39.4%) were benign and 43/71 (60.6%) were malignant. SFTs with NICTH were more likely to be malignant and present at a higher rate than previously published (5%–10.4%). The malignancy rate of extrathoracic SFTs was higher than that of thoracic SFTs, 20 (66.7%) as compared with 23 (56.1%). Age of onset varied from 24 to 85 years (mean 59 years), with 47 males and 28 females, and gender unavailable for 1 case. When comparing clinical characteristics of patients with benign as compared malignant tumors, no significant differences in the age of onset, gender, or size of tumor were seen. Among 15/19 cases, the insulin-like growth factor II (IGF-II)/IGF-I ration was >10.0. Complete tumor resection remained the only definitive treatment.Outcomes and lessens:Glucocorticoids dose-dependently reduce the frequency and severity of hypoglycemic episodes. Low doses of prednisone were ineffective at relieving hypoglycemia. The effect of neoadjuvant treatment, consisting of chemoradiation, and consecutive selective embolization of vessels feeding the tumor were not identified.

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Section: Treatmentmentioning

confidence: 99%

Doege–Potter syndrome

Han¹,

Zhang²,

Xing-bin³

et al. 2017

Medicine

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“…Low IGF1 levels in patients with NICTH are related to chronic attenuation of GH secretion due to the negative feedback of IGF2. 8,12,13 There is no clear standard of care for managing non-islet-cell tumor hypoglycemia. Ideal treatment includes complete tumor resection.…”

Section: Discussionmentioning

confidence: 99%

Doege-Potter syndrome associated to metastatic solitary fibrous tumor

Andrade¹,

Sousa²,

Amaral³

et al. 2022

Autops Case Rep

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Solitary fibrous tumor (SFT) is a rare fibroblastic mesenchymal neoplasm with an estimated annual incidence of 0.35 per 100,000 individuals. Doege-Potter syndrome is a paraneoplastic syndrome related to solitary fibrous tumor clinically characterized by hypoglycemia, occurring in less than 5% of cases. Herein, we report a case of metastatic SFT associated with recurrent severe hypoglycemia. A 43-year-old male with a noncontributory medical history presented with a painless and progressive growing mass in the right thigh. The histological evaluation rendered the diagnosis of SFT, and tumor resection was performed. One year after the operation, on the oncological follow-up, he was admitted to the emergency unit, manifesting an early-morning seizure associated with a severe hypoglycemia. The laboratory findings of non-islet cell tumor hypoglycemia (NICTH) in the background of a relapsed metastatic solitary fibrous tumor were consistent with the diagnosis of Doege-Potter syndrome. Hepatic embolization associated with oral glucocorticoid was an efficient palliative treatment to control the hypoglycemic crisis and allow hospital discharge.

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“…The glucose levels stabilized on 6 and 8 mg daily of rhGH daily [4]. Others reported the use of up to 12 mg of rhGH daily for treatment of malignancy-induced hypoglycemia [5]. It should be noted that use of rhGH should reduce the need for other therapies, such glucocorticoid therapy, the latter of which puts patients at a high risk for pathologic fractures, especially in the setting of concomitant bone metastases.…”

Section: Discussionmentioning

confidence: 99%

“…Unlike glucocorticoids, experts recommend limiting the use of rhGH within the realm of palliation, in end-stage cancers, due to its potential for accelerating tumor growth. Few case reports have been published on the use of rhGH in NICTH, the majority of which have been reported in palliative care settings [4,5]. Herein, we report the successful use of rhGH, outside of the conventional palliation window, in treating severe and refractory NICTH, without altering the patient's oncological outcome.…”

Section: Introductionmentioning

confidence: 90%

Growth hormone therapy in non-islet cell tumor mediated hypoglycemia associated with metastatic lung adenocarcinoma

Ca¹,

Tsm²,

Fa³

et al. 2017

Clin Med Invest

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Severe hypoglycemia is a rare but serious sequela of malignancy. It may be seen with either islet or non-islet cell tumors. Treatment of non-islet cell tumor mediated hypoglycemia (NICTH) is often challenging, especially when rapid tumor debulking is not feasible. Medical therapies with glucocorticoids and enteral feeds have been utilized in the past, but with limited success. The use of recombinant human growth hormone (rhGH) in cases of NICTH, although seemingly effective, has been limited to end-stage cancers, due to its potential for accelerating tumor growth. Here, we report the successful use of rhGH in severe and refractory NICTH, in a patient with non-operable metastatic lung adenocarcinoma, without altering the patient's oncological outcome.

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Non-islet cell tumour hypoglycaemia

Cited by 4 publications

References 14 publications

Doege–Potter syndrome

Doege–Potter syndrome

Doege-Potter syndrome associated to metastatic solitary fibrous tumor

Growth hormone therapy in non-islet cell tumor mediated hypoglycemia associated with metastatic lung adenocarcinoma

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