en Surgery Surgery case report case report <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="color:#0000ff;"><strong><em>Background</em></strong><em>:</em></span> Tumor-associated hypoglycemia can be caused by non-islet cell tumors including gastrointestinal stromal tumor (GIST) which is a rare paraneoplastic syndrome that leads to the release of insulin-like growth factor-2 (IGF-2).<br> <span style="color:#0000ff;"><strong><em>Case Presentation</em></strong><em>:</em></span> We report the case of a 45-year old woman who was admitted to our hospital with refractory hypoglycemic episodes. We found normal serum insulin and c-peptide level and abdominal CT-scan showed a small duodenal wall lesion suggesting insulinoma. After tumor resection, hypoglycemia symptoms were recovered, but the pathological findings demonstrated the lesion was GIST.<br> <span style="color:#0000ff;"><strong><em>Conclusion</em></strong><em>:</em></span> In a small gastrointestinal lesion with hypoglycemic symptoms we should consider IGF-II secreting GIST in addition to insulinoma.</span></span> Hypoglycemia, GIST, IGF-II 447 450 http://caspjim.com/browse.php?a_code=A-10-1719-1&slc_lang=en&sid=1 Foolad Eghbali foolade@yahoo.com 100319475328460031231 100319475328460031231 No Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran Reza Karami reza_karami1367@yahoo.com 100319475328460031232 100319475328460031232 Yes Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran