Introduction
Tumor-induced hypoglycemia (TIH) is rare and is almost due to excessive
secretion of insulin by the tumor. However, TIH has been recently
associated with the non islet-cell tumor hypoglycemia (NICTH)
syndrome1. The underlying mechanism of hypoglycemia is
production of incompletely processed insulin-like growth factor 2
(IGF-2).
Although the actual prevalence is not known, NICTH occurs in patients
with solid tumors of mesenchymal or epithelial origin. For epithelial
tumors, hepatocellular carcinoma (HCC) is the most
frequent2. Rarely, NICTH has been observed as the
initial manifestation of HCC3.
We present a patient who presented with severe hypoglycemia and was
diagnosed with advanced HCC producing IGF2.