Management of Non-Islet Cell Tumor Hypoglycemia Induced by Adrenal Cortical Carcinoma

Non-islet cell tumor hypoglycemia (NICTH) is a rare paraneoplastic syndrome that significantly worsens the prognosis of underlying malignancies. It is characterized by hypoglycemia resulting from ectopic production of insulin-like growth factor 2. NICTH caused by adrenal cortical carcinoma (ACC) is extremely rare. To date, no curative treatment of nonoperable NICTH has been reported. In this report, we describe a case of ACC-induced NICTH that was refractory to multiple treatments for hypoglycemia. It provides diagnostic and treatment approaches for NICTH and emphasizes the limitations of existing medical therapies for NICTH.