Abstract
A 55 year old female presented large left upper quadrant mass and episodes of recurrent hypoglycemia. Preoperative laboratory testing revealed normal insulin, IGF-I and IGF-II levels. Big-IGF-II levels were unable to be measured because the laboratory test was unavailable. A CT scan of her abdomen and pelvis revealed a large 19 × 15 × 12 cm left upper quadrant mass appearing to involve the pancreas, spleen, and left kidney. The mass was surgically extirpated and was consistent with a hemangiopericytoma. Subsequently, her hypoglycemic attacks along with abdominal symptoms resolved. We hypothesize that this patient’s hypoglycemic attacks were a consequence of tumor secretion of a pro-hormone form of IGF-II called ‘Big IGF-II’.
Highlights
Sarcomas are soft tissue tumors of mesenchymal origin, comprising about 1% of all adult malignancies
Soft tissue solitary fibrous tumor (SFT), otherwise known as hemangiopericytoma, is a rare tumor that represents less than 2% of sarcomas [1]
With this histology and hypoglycemia, there has been an association related to insulin like growth factors (IGF) I/II which were tested
Summary
Sarcomas are soft tissue tumors of mesenchymal origin, comprising about 1% of all adult malignancies. A 55 year old female with history of ulcerative colitis presented to the hospital with complaints of fatigue, nausea, episodic diaphoresis, tachycardia, and vague, intermittent left upper quadrant pain that started about three months prior. A CT scan of her abdomen and pelvis was performed with discovery of a large 19 × 15 × 12 cm left upper quadrant mass appearing to involve the pancreas, spleen, and left kidney. A CT guided biopsy of the mass was performed and the histopathologic report was consistent with hemangiopericytoma With this histology and hypoglycemia, there has been an association related to insulin like growth factors (IGF) I/II which were tested. She has continued radiographic surveillance with CT scan of her abdomen and pelvis
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