Severe paraneoplastic hypoglycemia due to a non-islet cell tumor in a patient with an advanced gastrointestinal stromal tumor

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract, mainly localized in the stomach. Most GISTs derive from mutations in tyrosine kinase receptors or platelet-derived growth factor receptor-α. GISTs are rarely associated with paraneoplastic hypoglycemia caused by a non-β-cells tumor. This syndrome, defined non-islet cell tumor hypoglycemia (NICTH), arises from excess tumor production of insulin-like growth factor. We describe the case of a 67-year-old female with severe NICTH secondary to an advanced and metastatic GIST.