Recurrent Hypoglycemia Triggered by Sorafenib Therapy in a Patient with Hemangiopericytoma

Abstract

Targeted therapy has been proven to be one of the most effective cancer treatments. However, some endocrine disorders can occur during treatment with targeted agents. We report the case of a patient who exhibited a wax and wane pattern of hypoglycemia that was attributed to sorafenib therapy. A 32-year-old woman with metastatic hemangiopericytoma visited the emergency department in a stuporous state. Nonhyperinsulinemic hypoglycemia was diagnosed, was exacerbated shortly after sorafenib therapy, and was improved by the cessation of sorafenib with additional glucocorticoid therapy. Patients with metastatic hemangiopericytoma should be carefully monitored with particular attention to hypoglycemia when sorafenib therapy is initiated.

Case report of severe Cushing’s syndrome in medullary thyroid cancer complicated by functional diabetes insipidus, aortic dissection, jejunal intussusception, and paraneoplastic dysautonomia: remission with sorafenib without reduction in cortisol concentration

“…We postulate a similar action of sorafenib on mineralocorticoid and glucocorticoid receptors in our patient. It is of note that insulin-independent hypoglycemia was induced by sorafenib in a patient with hemangiopericytoma and was responsive to glucocorticoid treatment [ 20 ].…”

Multidisciplinary Approach to Hepatic Metastases of Intracranial Hemangiopericytoma: A Case Report and Review of the Literature

“…Clinical symptoms are vague and nonspecific, depending on tumor location and size [ 4 ]. Pain is usually a late presentation, while hypoglycemia represents a unique endocrine paraneoplastic syndrome, caused by oversecretion of insulin-like growth factor II [ 5 ].…”

“…The rationale behind their use is the expression of platelet-derived growth factor receptor (PDGFR) and vascular endothelial growth factor receptor (VEGFR) by the HPC tumor cells. Small experimental trials or case reports have been published to date, reporting partial response or stable disease course for several months; however, these results need validation in larger controlled studies [ 2 , 5 , 15 – 17 ].…”

Articles in 'Endocrinology and Metabolism' in 2014

“…Other excellent articles on basic endocrine research have also been published [ 60 , 61 , 62 ]. Finally, interesting case reports on patients with various endocrine diseases appeared in 2014 in ' Endocrinology and Metabolism ' [ 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ].…”