[Paraneoplastic hypoglycemia in localized fibrous tumors of the pleura].
Localized fibrous tumor of the pleura is a rare, slowly growing, benign tumor which originates from the submesothelial stem cells of the pleura visceralis. Most of these tumors clinically behave asymptomatically, although tumor-associated hypoglycemia occurs in a few cases and can lead to hypoglycemic coma. Laboratory investigations show significant elevation of paraneoplastic IGF-II with a 2-3 times higher effect on the blood glucose level than insulin. Further, one finds reduced synthesis of IGFBP-3, which inhibits the action of IGF-II by inducing a complex with the paraneoplastic protein. As treatment, surgical resection of the tumor is recommended. We report on the case of a 72-year-old man with diabetes mellitus type II, who complained of recurrent hypoglycemic episodes. Diagnostic evaluation showed a fibrous tumor attached to the right diaphragm. After surgical treatment the hypoglycemic episodes disappeared.
Kerber
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Abteilung für Allgemeine Chirurgie, Chirurgische Universitätsklinik, Tübingen.
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010994:Pleura / Q000473:pathology / Q000601:surgery; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
Paraneoplastische Hypoglykämie beim lokalisierten fibrösen Tumor der Pleura.