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 Tominaga; Chiaki Kawarasaki; Keiko Kanemoto; Akio Yokochi; Keishi Sugino; Kazuhito Hatanaka; Toshimasa Uekusa; Izumi Fukuda; Motohiko Aiba; Naomi Hizuka; Susumu Uda

doi:10.2169/internalmedicine.51.7906

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 Tominaga, Chiaki Kawarasaki, Keiko Kanemoto, Akio Yokochi, Keishi Sugino, Kazuhito Hatanaka, Toshimasa Uekusa, Izumi Fukuda, Motohiko Aiba, Naomi Hizuka, Susumu Uda

Author information

Naoto Tominaga
Division of Nephrology and Metabolism, Kanto Rosai Hospital, Japan
Chiaki Kawarasaki
Division of Nephrology and Metabolism, Kanto Rosai Hospital, Japan
Keiko Kanemoto
Division of Nephrology and Metabolism, Kanto Rosai Hospital, Japan
Akio Yokochi
Division of Nephrology and Metabolism, Kanto Rosai Hospital, Japan
Keishi Sugino
Department of Pathology, Kanto Rosai Hospital, Japan
Kazuhito Hatanaka
Department of Pathology, Kanto Rosai Hospital, Japan
Toshimasa Uekusa
Department of Pathology, Kanto Rosai Hospital, Japan
Izumi Fukuda
Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women's Medical University, Japan
Motohiko Aiba
Department of Surgical Pathology, Tokyo Women's Medical University Medical Center East, Japan
Naomi Hizuka
Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women's Medical University, Japan
Susumu Uda
Division of Nephrology and Metabolism, Kanto Rosai Hospital, Japan

Keywords: solitary fibrous tumor of the pleura, non-islet cell tumor hypoglycemia, high-molecular-weight insulin-like growth factor II, platelet-derived growth factor receptor tyrosine kinase

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 23 Pages 3267-3272

DOI https://doi.org/10.2169/internalmedicine.51.7906

Details

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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