Hata Tatsuo, Tsuruta Yoshihiko, Takamori Shigeru, Shishikura Yuri
Department of Surgery, Chiba Tokushukai Hospital, Funabashi, Japan.
Case Rep Oncol. 2012 May;5(2):420-7. doi: 10.1159/000340012. Epub 2012 Aug 1.
An 83-year-old man underwent complete resection of a large malignant solitary fibrous tumor in the retroperitoneum in 2006 and of a local recurrent tumor in 2010. In 2011, he was admitted to our hospital because of hypoglycemia. His serum glucose level was very low, and his levels of insulin and C-peptide were low. Furthermore, he had a recurrent tumor in the retroperitoneum and pelvis. Immediately after the third surgery for complete resection, he had no hypoglycemic episodes and his serum glucose level was within the normal range. Immunoblotting analysis revealed a high-molecular-weight form of insulin-like growth factor II in the patient's serum and in the protein extract obtained from the resected specimen in 2011. To our knowledge, this is the first report of non-islet cell tumor hypoglycemia caused by a malignant solitary fibrous tumor secreting a high-molecular-weight form of insulin-like growth factor II at the second recurrence.
一名83岁男性在2006年接受了腹膜后巨大恶性孤立性纤维瘤的完整切除，并于2010年接受了局部复发性肿瘤的切除。2011年，他因低血糖入住我院。他的血清葡萄糖水平非常低，胰岛素和C肽水平也很低。此外，他在腹膜后和骨盆有复发性肿瘤。在第三次完整切除手术后，他立即没有低血糖发作，血清葡萄糖水平在正常范围内。免疫印迹分析显示，患者血清以及2011年从切除标本中获得的蛋白质提取物中存在高分子量形式的胰岛素样生长因子II。据我们所知，这是首例由分泌高分子量形式胰岛素样生长因子II的恶性孤立性纤维瘤在第二次复发时引起的非胰岛细胞瘤低血糖症的报告。
