title: Paraneoplastic Hypoglycaemia: A Rare Manifestation of Pelvic Gastrointestinal Stromal Tumour.
abstract: Non-Islet Cell Tumour Induced Hypoglycaemia (NICTH), presenting with recurrent fasting hypoglycaemia is a very rare paraneoplastic syndrome. It usually presents with large metastatic mesenchymal tumours. NICTH secondary to Gastrointestinal Stromal Tumour (GIST) is even rarer. Diagnosis of NICTH is based on the low serum insulin level, low serum concentrations of Insulin Like Growth Factor (IGF-I) and IGF binding protein- III (IGFBP-III) in combination with elevated concentrations of pro-IGF-II. Various Immunohistochemical (IHC) markers are integral to diagnosis of GIST namely 2-deoxyglucose-6-phosphate phosphatase -1(DOG-1), Cluster Differentiation 34 (CD 34), Cluster Differentiation 117 (CD117). The management requires prompt intravenous hydration and glucose infusions followed by surgical resection. We hereby, report a rare case of a 65-year-old female with intractable fasting hypoglycaemia due to overproduction of "big" insulin-like growth factor II diagnosed to have pelvic GIST and managed by Steroids and Imatinib.
authors.affiliation: Associate Professor, Department of Surgical Oncology, Dr. RMLIMS , Lucknow, Uttar Pardesh, India .
authors.forename: Ashish
authors.initials: A
authors.lastname: Singhal
authors.affiliation: Associate Professor, Department of Radiation Oncology, Dr. RMLIMS , Lucknow, Uttar Pardesh, India .
authors.forename: Rahat
authors.initials: R
authors.lastname: Hadi
authors.affiliation: Associate Professor, Department of Pathology, Dr. RMLIMS , Lucknow, Uttar Pardesh, India .
authors.forename: Kiranpreet
authors.initials: K
authors.lastname: Mehrotra
authors.affiliation: Assistant Professor, Department of Critical Care Medicine, Dr. RMLIMS , Lucknow, Uttar Pardesh, India .
authors.forename: Shivani
authors.initials: S
authors.lastname: Rastogi
authors.affiliation: Associate Professor, Department of Gastro-surgery, Dr. RMLIMS , Lucknow, Uttar Pardesh, India .
authors.forename: Shakeel
authors.initials: S
authors.lastname: Masood
keywords: Mesenchymal tumour; Non-islet cell; Paraneoplastic syndrome