A Case of Ileal Mesenteric Solitary Fibrous Tumor (Producing Hormone) with Ventricular Fibrillation

Abstract

A 61-year-old woman was brought into our hospital by ambulance because of unconsciousness due to hypoglycemia. A huge abdominal tumor was palpated. Non-islet-cell tumor hypoglycemia (NICTH) due to the abdominal tumor was likely and we started sustained administration of glucose. On the third hospital day, she developed ventricular fibrillation (VF) due to hypokalemia, for that defibrillation successfully resumed the heart beat. Thereafter strict management of blood glucose and electrolytes levels was kept, and the tumor was removed on the 20^th hospital day. After the operation, both hypoglycemia and hypokalemia improved and declined blood peptide C and insulin levels were normalized. Histopathology revealed patternless proliferation of spindle shaped cells. The tumor cells were CD34 (+), bcl-2 (+), SMA (-), and c-kit (-) on immunohistochemistry. Solitary fibrous tumor was thus diagnosed.
Although we sometimes encounter case reports of NICTH caused by solitary fibrous tumor arising in the mesentery, this is the first case of NICTH in which abrupt onset of hypokalemia caused VF. This case which appears to be instructive is presented here.