title: A case report of non-islet cell tumour hypoglycaemia associated with ovarian germ-cell tumour.
abstract: BACKGROUND
  Non-islet cell tumour hypoglycaemia is a rare paraneoplastic condition in which tumours secrete a high-molecular-weight precursor of insulin-like growth factor-II causing hypoglycaemia and can be difficult to identify and treat.
  
  
  METHODS
  This is the case of a 27-year-old patient from Africa with metastatic ovarian yolk sac tumour who presented with hypoglycaemia and was subsequently diagnosed with non-islet cell tumour hypoglycaemia.
  
  
  RESULTS
  Our patient required higher doses of glucocorticosteroids than reported in the literature in combination with recombinant growth hormone therapy in order to control her hypoglycaemia.
  
  
  METHODS
  This is the first case of non-islet cell tumour hypoglycaemia described in association with a germ-cell tumour. Her management required collaboration between the endocrinology team, the palliative care team, the acute medicine team and physicians in Africa to enable her safe journey home.
  
  
  CONCLUSIONS
  This case illustrates the need for awareness among general physicians of rare tumour manifestations and the need for multidisciplinary input for the optimal management of these patients.
authors.affiliation: SpR Acute Medicine, Frenchay Hospital, Bristol, UK. louisepowter@nhs.net
authors.forename: Louise
authors.initials: L
authors.lastname: Powter
authors.forename: Suzanne
authors.initials: S
authors.lastname: Phillips
authors.forename: Emma
authors.initials: E
authors.lastname: Husbands
mesh_terms: D000328:Adult; D018240:Endodermal Sinus Tumor / Q000150:complications*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications*; D010051:Ovarian Neoplasms / Q000150:complications*; D010348:Patient Care Team / Q000458:organization & administration