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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Late-onset non-islet cell tumor hypoglycemia: A case report
Shunichi Matsumoto, Eijiro Yamada, Yasuyo Nakajima, Naoki Yamaguchi, Takashi Okamura, Toshiki Yajima, Satoshi Yoshino, Kazuhiko Horiguchi, Emi Ishida, Masashi Yoshikawa, Jun Nagaoka, Sho Sekiguchi, Mai Sue, Shuichi Okada, Izumi Fukuda, Ken Shirabe, Masanobu Yamada
Shunichi Matsumoto, Eijiro Yamada, Yasuyo Nakajima, Naoki Yamaguchi, Takashi Okamura, Satoshi Yoshino, Kazuhiko Horiguchi, Emi Ishida, Masashi Yoshikawa, Jun Nagaoka, Sho Sekiguchi, Mai Sue, Shuichi Okada, Masanobu Yamada, Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi 371-8511, Gunma, Japan
Toshiki Yajima, Ken Shirabe, Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, Maebashi 371-8511, Gunma, Japan
Izumi Fukuda, Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine Nippon Medical School, Tokyo 1138602, Japan
Author contributions: Yamada E contributed to the care of the patient, data collection, the literature review, and drafting the manuscript; Matsumoto S contributed to the care the patient, data collection and the literature review; Nakajima Y, Yamaguchi N, Okamura T and Yajima T contributed to the care of the patient; Yoshino S, Horiguchi K and Ishida E contributed to drafting the manuscript; Yoshikawa M, Nagaoka J, Sekiguchi S and Sue M contributed to the care of the patient; Okada S contributed to the drafting of the manuscript; Fukuda I contributed data on performing the procedure; Shirabe K and Yamada M did critical revisions to the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Eijiro Yamada, MD, PhD, Senior Lecturer, Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi 371-8511, Gunma, Japan.
eijiro.yamada@gunma-u.ac.jp
Received: April 2, 2020
Peer-review started: April 2, 2020
First decision: November 3, 2020
Revised: November 13, 2020
Accepted: November 29, 2020
Article in press: November 29, 2020
Published online: January 6, 2021
Processing time: 273 Days and 22.3 Hours
BACKGROUND
Hypoglycemia due to non-insulin-producing tumors is referred to as non-islet cell tumor hypoglycemia (NICTH). As NICTH is a rare lesion, the natural course of NICTH is not well understood. We report a case of NICTH that was observed 30 years before the onset of hypoglycemia.
CASE SUMMARY
A 50-year-old man was diagnosed with an abnormal right chest shadow during a routine X-ray examination, but no further examination was undertaken because the lesion appeared benign. Thirty years after the tumor discovery, the patient was admitted to the hospital with symptoms of severe hypoglycemia, which was diagnosed as NICTH based on a complete examination. The tumor was resected and found to be a solitary fibrous mass (15.6 cm × 13.7 cm × 10.4 cm); thereafter, the patient’s blood glucose levels normalized and he completely recovered.
CONCLUSION
NICTH can have an acute onset, even if the tumor has been present and asymptomatic over a long time period.
Core Tip: Since hypoglycemia due to non–insulin-producing tumors is a rare lesion, so the natural course of non-islet cell tumor hypoglycemia (NICTH) is not well understood. Here we describe a rare case of NICTH that was caused by a tumor that had been asymptomatic for 30 years. To our knowledge, this is the longest reported latency period before the onset of severe hypoglycemia. The sudden-onset of severe hypoglycemia in the patient described in this report indicates that NICTH can have an acute onset even when the tumor has been present for a longer time.
