低血糖を併発した perivesical solitary fibrous tumor の1例

Abstract

Some non-islet tumors can induce hypoglycemia. We report a case of a solitary fibrous tumor (SFT) as perivesical mass associated with hypoglycemia. A 61-year-old man was admitted to our department with recurrent hypoglycemic attack and lower abdominal discomfort, but no symptom of urination. Ultrasonography and magnetic resonance imaging demonstrated a giant heterogeneous mass in the pelvic and rightward shift of bladder, but the tumor's border was clear. Endocrinological analyses showed high serum levels of insulin-like growth factor II (IGF-II) and suppressed secretion of insulin. We removed perivesical tumor that weighed 720 g on 30th January in 2003. After the removal, serum IGF-II levels returned to normal and hypoglycemic attacks ceased. Pathological examination revealed well-circumscribed nodular mass composed of uniform spindle cells arranged in bundles and fascicles with varying amounts of collagen and reticulin fibers. Almost all of the tumor cells were immunohystochemically positive for vimentin and CD34, negative for cytokeratin.