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Abstract

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Article in Japanese

Case Report

A case of solitary pleural fibrous tumor with nonislet-cell tumor hypoglycemia producing big insulin-like growth factor-II

Miyuki Takahashia,b  Shunsuke Endob  Nirei Noguchic  Shoichiro Nagasakac  Shun Ishibashic  Takehiko Yamaguchid 

aDepartment of Anesthesiology and Intensive Care Medicine, Jichi Medical University
bDepartment of General Thoracic Surgery, Jichi Medical University
cDivision of Endocrinology and Metabolism, Jichi Medical University
dDepartment of Diagnostic Pathology, Jichi Medical University

ABSTRACT

We herein reported a 75-year-old man who presented to our hospital with hypoglycemia. Blood tests revealed that insulin secretion was suppressed, and serum concentrations of insulin-like growth factor (IGF) -1 and IGF-II did not increase. However, Western blot analysis suggested the presence of big IGF-II in his serum. Chest computed tomography showed a well-demarcated solid mass, 20 cm in the longest diameter, containing heterogenous components in the left thoracic cavity. Fine needle biopsy suggested a solitary fibrous tumor. Operative findings showed a solid tumor attached by a pedicle to the diaphragmatic portion of the left visceral pleura after left thoracotomy. Tumor resection and concomitant partial pulmonary resection of the left lower lobe was successful. Operation time was 209 min and blood loss was 220 ml. Diagnosis of a malignant solitary fibrous tumor arising from the visceral pleura producing big IGF-II was made by immunohistochemical staining. Hypoglycemia had not been documented just after surgery. No tumor recurrence is found 3.5 years after surgery.

KEYWORDS

Solitary fibrous tumor  Pleura  Non-islet cell tumor hypoglycemia  Surgery  Big IGF-II 

Received 10 Dec 2013 / Accepted 19 Jun 2014

AJRS, 3(5): 680-684, 2014

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