J Cancer 2019; 10(26):6475-6480. doi:10.7150/jca.30472

Review

Hypoglycemia as a Symptom of Neoplastic Disease, with a focus on Insulin-like Growth Factors Producing Tumors

Jan Schovanek1, Lubica Cibickova1, Filip Ctvrtlik2, Zbynek Tudos2, David Karasek1, Maurizio Iacobone3, Zdenek Frysak1✉

1. Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
2. Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
3. Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy, Via Giustiniani 2, 35128 Padova, Italy.

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Citation:
Schovanek J, Cibickova L, Ctvrtlik F, Tudos Z, Karasek D, Iacobone M, Frysak Z. Hypoglycemia as a Symptom of Neoplastic Disease, with a focus on Insulin-like Growth Factors Producing Tumors. J Cancer 2019; 10(26):6475-6480. doi:10.7150/jca.30472. Available from http://www.jcancer.org/v10p6475.htm

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Abstract

This article reviews the current knowledge of uncommon causes of hypoglycemia, with a focus on neoplastic disease. However, these situations are rare. They commonly accompany severely ill patients and therefore a proper diagnosis is the basis for relevant treatment. Here we discuss the pathophysiological foundation of hypoglycemia - situations caused by increased insulin production or sensitivity - but we also focus on different cytokines which could cause hypoglycemia, especially IGF-II production in what are called nonislet cell tumors. From the clinical perspective we can divide the patients who are affected into "seemingly ill” or “healthy patients” and lead the diagnostic process accordingly.

Keywords: Nonislet cell tumor (NICT), Nonislet cell tumor hypoglycemia (NICTH), insulin-like growth factor 2 (IGF-II), Adrenal Glands