A Case of Non-islet Cell Tumor Hypoglycemia with Malignant Solitary Fibrous Tumor of the Pleura

Kataoka Youko, Oshio Mayumi, Igarashi Tomoyuki, Motoishi Makoto, Sawai Satoru, Hanaoka Jun

doi:10.2482/haigan.53.59

Background. Non-islet cell tumor hypoglycemia (NICTH) caused by non-pancreatic tumors is rare. Here, we report a case of NICTH that was associated with malignant solitary fibrous tumor (SFT) of the pleura, and was treated with glucocorticoid therapy. Case. A 72-year-old man presented with an abnormal shadow in the chest on medical health examination. A chest computed tomography (CT) scan confirmed the presence of a tumor shadow, approximately 12×9×8 cm in size, in the right upper lung field. A right upper lobectomy with chest wall resection and lymph node dissection were performed. Pathological findings of the resected specimens revealed malignant SFT arising from the pleura. Three years after the operation, multiple intrathoracic and inguinal lymph node recurrences were detected on CT. We decided to observe the natural course of recurrence without giving chemotherapy. Four years after the operation, he was admitted to our department with recurrent hypoglycemic attacks. Glucose infusion and intravenous hyperalimentation were not effective, and he experienced repeated hypoglycemic attacks. Based on the clinical course and examination results, we diagnosed NICTH associated with malignant SFT. After administration of oral glucocorticoids, the hypoglycemia improved. However, it was slightly difficult to regulate the dose of oral glucocorticoid. Conclusion. Glucocorticoid therapy is useful for treating NICTH with SFT and can be tailored to the individual's needs.<br>

A Case of Non-islet Cell Tumor Hypoglycemia with Malignant Solitary Fibrous Tumor of the Pleura

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