Non-islet cell tumour hypoglycaemia.

Non-islet cell tumour hypoglycaemia is a rare paraneoplastic phenomenon where there is spontaneous hypoglycaemia due to secretion of insulin-like growth factor-2 (IGF-2) from large mesenchymal or epithelial tumours. A 67-year-old man presented to the accident and emergency department with a 6-week history of confusion and collapse. Investigations confirmed that he was having recurrent hypoglycaemic attacks. He had been diagnosed with a pelvic solitary fibrous tumour 1 year previously. Further tests demonstrated a high circulating level of IGF-2, which was being secreted by the tumour, confirming a diagnosis of non-islet cell tumour hypoglycaemia. The episodes of hypoglycaemia have resolved following treatment with glucocorticoids. He is currently awaiting radiotherapy.