title: A Case of Giant Borderline Phyllodes Tumor of the Breast Associated with Hypoglycemia.
abstract: We report a patient with a giant phyllodes tumor of the right breast associated with a hypoglycemic attack. A 48-year-old woman experienced a loss of consciousness and was transferred via ambulance to our hospital emergency department. Upon arrival, her blood glucose level was 26 mg/dl, and a giant tumor (>20 cm in diameter) with skin ulceration was observed on the right breast. Core needle biopsy led to a histological diagnosis of a phyllodes tumor of the breast. Ultrasonography and computed tomography detected neither distant metastasis nor a pancreatic endocrine tumor. Her preoperative serum insulin-like growth factor (IGF)-II and insulin levels were 1,330 ng/ml (normal range, 519-1067 ng/ml) and <1.0 µU/ml, respectively. Following a simple mastectomy, the 24-h postoperative serum IGF-II and insulin levels were 496 ng/ml and 10.0 µU/ml, respectively. The IGF-II levels detected in the phyllodes tumor and normal breast tissue were 10,600 ng/Wg (wet weight in grams) and 855 ng/Wg. We conclude from these findings that the hypoglycemic attack was related to the elevated IGF-II level in the giant phyllodes tumor of the breast.
authors.affiliation: Department Endocrine Breast Surgery, Tokai University School of Medicine Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo 192-0032, Japan. yu-ki@is.icc.u-tokai.ac.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Saito
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Chie
authors.initials: C
authors.lastname: Inomoto
authors.forename: Nobue
authors.initials: N
authors.lastname: Kumaki
authors.forename: Kozue
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Rin
authors.initials: R
authors.lastname: Ogiya
authors.forename: Risa
authors.initials: R
authors.lastname: Oshitanai
authors.forename: Mayako
authors.initials: M
authors.lastname: Terao
authors.forename: Banri
authors.initials: B
authors.lastname: Tsuda
authors.forename: Tooru
authors.initials: T
authors.lastname: Morioka
authors.forename: Naoki
authors.initials: N
authors.lastname: Niikura
authors.forename: Takuho
authors.initials: T
authors.lastname: Okamura
authors.forename: Shinobu
authors.initials: S
authors.lastname: Masuda
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tokuda
mesh_terms: D062005:Biopsy, Large-Core Needle; D001943:Breast Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism* / Q000601:surgery; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007335:Insulin-Like Growth Factor II / Q000378:metabolism*; D008408:Mastectomy; D008875:Middle Aged; D003557:Phyllodes Tumor / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism* / Q000601:surgery
chemical_list: D007335:Insulin-Like Growth Factor II