{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:32:34Z","timestamp":1793082754772,"version":"4.5.0"},"reference-count":21,"publisher":"The Endocrine Society","issue":"6","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Non\u2013islet cell tumor hypoglycemia as a result of insulin-like growth factor (IGF)-2 secretion is rare. A 59-year-old woman was referred with postmenopausal bleeding due to endometrial hyperplasia. Serum testosterone, estradiol, and adrenal androgens were elevated with suppressed gonadotropin concentrations. Cross-sectional imaging demonstrated a large left adrenal mass. The patient subsequently presented acutely with hypoglycemia. During a supervised fast, symptomatic hypoglycemia occurred within 5\u2005hours. Serum samples drawn prior to hypoglycemia correction revealed an elevated IGF-2:IGF-1 ratio of 60.7 (normal &amp;lt;10) with low paired C-peptide and insulin, consistent with an IGF-2\u2013secreting tumor. Hypoglycemia was managed with low-glycemic index foods and radical surgical excision was undertaken. Postoperative pathology revealed an adrenocortical carcinoma (ACC); Ki67 12%; IGF-2 positive immunostaining. This case demonstrates a rare IGF-2\u2013secreting ACC causing clinically significant hypoglycemia with positive immunostaining for IGF-2 in addition to biochemical hyperandrogenism resulting in endometrial hyperplasia and postmenopausal bleeding. This case encompasses 2 unique syndromes from the cosecretion of both peptide factor and steroid hormone.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf078","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T07:42:16Z","timestamp":1745394136000},"source":"Crossref","is-referenced-by-count":2,"title":["Adrenocortical Carcinoma With 2 Distinct Syndromes From Secretion of Insulin-Like Growth Factor 2 and Steroid Hormones"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9252-149X","authenticated-orcid":false,"given":"Eibhl\u00edn Marie","family":"Lonergan","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Diabetes, Cork University Hospital , Cork T12 DFK4 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lok Yi Joyce","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes, Cork University Hospital , Cork T12 DFK4 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