The therapeutic challenge of a nonresectable solitary fibrous tumor in a hypoglycemic patient.
We report a patient with a nonresectable histologically benign solitary fibrous tumor who suffered from paraneoplastic non-islet cell tumor hypoglycemia (NICTH). Diagnostic workup revealed malignant characteristics in which the tumor showed up as, presumably, false-negative on fluorodeoxyglucose-positron emission tomography (FDG-PET), while being positive on tyrosine-PET. Neoadjuvant treatment, which consisted of combined chemo-radiation and consecutive selective embolization of the tumor feeding vessels, caused such a therapeutic effect, on both NICTH and reduction in tumor volume, that a secondary resection, with the patient in a normoglycemic status, was possible. Our report highlights several important issues in the management of the patient with a nonresectable solitary fibrous tumor with severe episodes of hypoglycemia due to NICTH.
de Boer
Jaap
J
Department of Medical Oncology, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Jager
Pieter L
PL
Wiggers
Theo
T
Nieboer
Peter
P
Machteld Wymenga
A N
AN
Pras
Elisabeth
E
Hoogenberg
Klaas
K
Sleijfer
Dirk T
DT
Suurmeijer
Albert J H
AJ
van der Graaf
Winette T A
WT
D000328:Adult; D017024:Chemotherapy, Adjuvant; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D007335:Insulin-Like Growth Factor II / Q000378:metabolism; D008297:Male; D020360:Neoadjuvant Therapy; D018218:Neoplasms, Fibrous Tissue / Q000188:drug therapy*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000188:drug therapy*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D007335:Insulin-Like Growth Factor II