Endocrinology and Metabolism

Case Reports

A Case of Gastrointestinal Stromal Tumor with Recurrent Hypoglycemia.: Sun Hee Ko, Seok Hwan Kim, Il Ho Maeng, Koon Soon Kim, Yi Sun Jang, Hye Soo Kim, Jong Min Lee, Suk Young Park, Sang Bum Kang; Endocrinol Metab. 2010;25(2):125-130. Published online June 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.2.125

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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 a rare 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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Impact of Hypoglycemia on Morbidity, Mortality, and Resource Utilization in Gastrointestinal Stromal Tumor: A Nationwide Analysis
Manasa Ginjupalli, Jayalekshmi Jayakumar, Arnold Forlemu, Anuj Raj Sharma, Praneeth Bandaru, Vikash Kumar, Kameswara Santosh Dheeraj Nalluri, Madhavi Reddy
Gastroenterology Insights.2025; 16(4): 36. CrossRef

The Case of Accelerated Linear Growth Despite Growth Hormone and Insulin-like Growth Factor-I Deficiency.: Kyeong Ju Lee, Jong Ryeal Hahm, Tae Sik Jung, Jung Hwa Jung, Soo Kyoung Kim, Jong Ha Baek, Won Hyun Lee, Han wook Yoo, Soon Il Chung; J Korean Endocr Soc. 2009;24(3):206-211. Published online September 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.3.206

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Abstract PDF

Here we describe a male patient who attained normal height despite combined hypopituitarism with an abnormal growth hormone-insulin-like growth factor (IGF)-I axis. When he was an 18-year-old, he presented with a short stature and underdeveloped external genitalia. The patient had not undergone normal pubertal development and he displayed a height below the fifth percentile. Hormonal and radiological studies revealed the findings of severe anterior pituitary hormone deficiency and an atrophic pituitary gland. There had been no recent follow-ups with the patient or medical treatment since that time. In the current presentation, the patient, now 22 years of age, had attained normal height, yet he remained prepubertal and showed manifestations of delayed bone age and combined hypopituitarism. In addition, the patient's IGF-II levels were increased for his age.

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Growth Without GH: A Case Series and Literature Review
Stefana Catalina Bilha, Cristina Preda, Letitia Leustean, Nada Akad, Anca Matei, Maria-Christina Ungureanu
Journal of Clinical Medicine.2025; 14(24): 8957. CrossRef

A Case of Epithelioid Hemangioendothelioma of the Pelvic Retroperitoneum with Hypoglycemia.: Ji Ryang Kim, Yun Kyung Jeun, Kee Tae Park, Yang Ho Kang, Seok Man Son, In Ju Kim, Yong Ki Kim, Kyung Un Choi, Kwang Jae Lee; J Korean Endocr Soc. 2007;22(6):440-445. Published online December 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.6.440

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Abstract PDF: Hypoglycemia caused by a non-islet cell tumor (NICT) is a rare condition. The mechanism of NICT-induced hypoglycemia is still unclear, but insulin-like growth factor-II (IGF-II) has been thought to play a major role in its development. NICT is usually of mesenchymal or epithelial cell origin, but reports on NICT of an endothelial cell origin, which causes hypoglycemia, have yet to surface. Here, we report on a case of a 63-year-old female patient who was diagnosed with epithelioid hemangioendothelioma-induced hypoglycemia. Epithelioid hemangioendothelioma is a borderline malignant vascular tumor that is of endothelial cell origin and usually occurs in soft tissue, skin, lung, and liver. It was observed that serum insulin, C-peptide, and IGF-I were reduced, but the IGF-II level was elevated in hypoglycemia. The PET-CT showed no abnormal glucose metabolism in the tumor. Dextrose fluid was administered to the patient to control hypoglycemia until the operation. For treatment and diagnosis, surgical resection of the tumor and total hysterectomy were performed. The specimen was noted to have epithelioid hemangioendothelioma. Hypoglycemia-related symptoms disappeared after surgical resection was performed.

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