Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Recurrent Solitary Fibrous Tumor of the Pleura with Malignant Transformation and Non-islet Cell Tumor-induced Hypoglycemia due to Paraneoplastic Overexpression and Secretion of High-molecular-weight Insulin-like Growth Factor II
Naoto TominagaChiaki KawarasakiKeiko KanemotoAkio YokochiKeishi SuginoKazuhito HatanakaToshimasa UekusaIzumi FukudaMotohiko AibaNaomi HizukaSusumu Uda
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JOURNALS OPEN ACCESS

2012 Volume 51 Issue 23 Pages 3267-3272

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Abstract

A 41-year-old man was diagnosed with a solitary fibrous tumor (SFT) of the pleura in the posterior mediastinum. Despite two surgeries for excision, the SFT recurred and progressed with direct invasion of the chest wall and bone metastases. He was hospitalized because of cerebral infarction and presented with recurrent severe hypoglycemia fourteen years later. High-molecular-weight (HMW) insulin-like growth factor II (IGF-II) was identified in the serum and tumor using Western blotting and immunohistochemistry. These findings suggested that the cause of the recurrent severe hypoglycemia was SFT production of HMW IGF-II, a mediator of non-islet cell tumor-induced hypoglycemia (NICTH).

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© 2012 by The Japanese Society of Internal Medicine
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