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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).

Citation

Naoto Tominaga, Chiaki Kawarasaki, Keiko Kanemoto, Akio Yokochi, Keishi Sugino, Kazuhito Hatanaka, Toshimasa Uekusa, Izumi Fukuda, Motohiko Aiba, Naomi Hizuka, Susumu Uda. 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. Internal medicine (Tokyo, Japan). 2012;51(23):3267-72


PMID: 23207122

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