J Korean Med Sci.  2001 Apr;16(2):220-224. 10.3346/jkms.2001.16.2.220.

Malignant solitary fibrous tumor of the pleura causing recurrent hypoglycemia; immunohistochemical stain of insulin-like growth factor i receptor in three cases

• Chang ED
• Lee EH
• Won YS
• Kim JM
• Suh KS
• Kim BK

• KMID: 648261
• DOI: http://doi.org/10.3346/jkms.2001.16.2.220

Abstract

We present three cases of malignant solitary fibrous tumors of the pleura (SFTP) that produced recurrent hypoglycemia. Removal of the tumors produced normoglycemia. The tumors were well circumscribed and lobulated, and consisted of firm masses weighing 1,150 g to 1,450 g with the greatest diameter of 15 to 20 cm. The tumors were composed of spindle cells in fascicles or in a haphazard arrangement and were highly cellular and mitotically active (3-8 mitoses/10 high-power fields), showing histologically malignant features. Ultrastructurally, fibroblastic features of the tumor cells were present. Insulin-like growth factors (IGF) have been implicated in the presentation of hypoglycemia. The serum insulin and C-peptide levels were not elevated. Serum IGF-I levels were also low with values of 97.4, 157.1 and 51.9 ng/mL (ref. 125-317 ng/mL), respectively. However, tumor cells were strongly positive for IGF-I receptor on immunohistochemical analysis. It is tempting to speculate that IGF-I contributes to the hypoglycemia, even though the circulating levels were low.

Keyword

Pleura; Neoplasms; Insulin-Like Growth Factor I (IGF I); Blood Glucose

MeSH Terms

Aged
Blood Glucose
Coin Lesion, Pulmonary/chemistry/*complications/pathology
Female
Human
Hypoglycemia/*etiology
Immunohistochemistry
Male
Middle Age
Pleural Neoplasms/chemistry/*complications/pathology
Receptor, IGF Type 1/*analysis
Recurrence