Hemangiopericytoma associated with hypoglycemia

Paullada, J J; Lisci-garmilla, A; Gonzáles-Angulo, Amador; Jurado-Mendoza, J; Quijano-Narezo, M; Gómez-Peralta, Leopoldo; Doria-Medina, Marcelo

doi:10.1016/0002-9343(68)90098-3

Cited by 72 publications

(5 citation statements)

References 21 publications

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“…Hypertrophic pulmonary osteoarthropathy (Pierre-Marie-Bamberger syndrome) has been described in 10–20% of patients [6,7]. In rare cases, hypoglycemia can occur secondary to secretion of insulin-like growth factor-2 [7,8]. …”

Section: Discussionmentioning

confidence: 99%

Mediastinal Solitary Fibrous Tumor Diagnosed by Endobronchial Ultrasound-Directed Biopsy

et al. 2017

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Patient: Male, 32Final Diagnosis: Mediastinal solitary fibrous tumorSymptoms: Cough • dyspnea • progressive dysphagia • worsening intermittent chest painMedication: —Clinical Procedure: Flexible bronchoscopy • endobronchial ultrasound (EBUS)Specialty: PulmonologyObjective:Rare diseaseBackground:Solitary fibrous tumors of the middle mediastinal space are uncommon and often not discovered until symptoms secondary to compression of adjacent structures occur. Diagnosis requires surgical biopsy and histological tissue analysis. We describe the ECHO appearance of the solitary fibrous tumor and successful non-invasive EBUS diagnosis. This method of diagnosis allowed for surgical planning for resection and allowed us to exclude non-surgical diseases, such as small cell carcinoma.Case Report:A 32-year-old man presented to his primary care physician with worsening intermittent chronic chest pain with recent progressive dysphagia, cough, and dyspnea. Physical examination and routine laboratory work-up were unrevealing. Chest radiograph and computed tomography (CT) of the chest revealed a middle mediastinal mass. Flexible bronchoscopy confirmed extrinsic compression of right and left bronchial trees. Endobronchial ultrasound (EBUS) was used to biopsy the mass and the diagnosis of solitary fibrous tumor was confirmed. The patient underwent successful tumor resection and was discharged home after an uneventful postoperative period.Conclusions:Endobronchial ultrasound-directed tissue biopsy is an appropriate modality for suspected solitary fibrous tumors of the mediastinum. To our knowledge, this is only the second reported case of SFT diagnosed by EBUSTBNA. Our case uniquely demonstrates the advantages of pre-surgical diagnosis of mediastinal masses with EBUS-TBNA when the diagnosis SFT is suggested on CT and US imaging.

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Section: Discussionmentioning

confidence: 99%

Mediastinal Solitary Fibrous Tumor Diagnosed by Endobronchial Ultrasound-Directed Biopsy

et al. 2017

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“…Flank ağrı genellikle kitlenin büyüklüğüyle ilişkilidir. Hipogliseminin, tümörün glukozu aşırı metabolize etmesi sonucu geliştiği düşünülmektedir (8). Hipertansiyonun ise tümör hücrelerinden renin salgılanması sonucu geliştiği ve cerrahi sonrası her ikisinin gerilediği bilinmektedir (9).…”

Section: Discussionunclassified

Renal Hemangiopericytoma

Bozkurt¹,

Yonguç²,

Arslan³

et al. 2015

Haseki

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ÖzetHemanjioperisitom genellikle pelvis, baş, boyun ve meninkslerde görülen perisit hücrelerinden köken alan nadir bir perivasküler tümördür. Üriner sistemde çok nadir görülür. Bu olgu sunumunda insidental olarak saptanan radyolojik olarak böbrek hücreli kanseri düşündüren renal kitle olgusu sunuldu. İlk olarak parsiyel nefrektomi yapılan hastaya pozitif cerrahi sınır gelmesi üzerine radikal nefrektomi uygulandı. Ek bir tedavi uygulanmadı. Abs tractHemangiopericytoma is an uncommon perivascular tumor originating from pericytes in the pelvis, head and tneck, and the meninges; extremely rarely in the urinary system. We report a case of incidentally detected renal mass in which radiologic evaluation was suggestive of renal cell carcinoma. First, we performed partial nephrectomy, and then, radical nephrectomy because of positive surgical margins and the pathological examination of the surgical specimen that revealed a hemangiopericytoma. No additional treatment was administered. (The Me di cal Bul le tin of Ha se ki 2015; 53: 80-2)

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“…In 7 of the 17 reviewed cases, an electronmicroscopic investigation supported the histopathological HAP diagnosis (1,2,5,7,38,39,54). In five of these publications it is reported that the authors had looked for secretory granules in the neoplastic parenchymal cells (1, 2, 5 , 7, 38), i.e., an important criterion for neuroendocrine differentiation.…”

Section: H a P Diagnosismentioning

confidence: 89%

“…In the review, it was observed that the IGF-2-induced NICTH symptoms obviously did not differ from those caused by regular hyperinsulinism; this also includes the effects on the CNS (2,5,7,11,13,21,28,37,38,39,46,47,54). Prompt relief was obtained after food intake.…”

Section: Igf-2 Ria Of Patient's Blood With Subsequent Gel Chromatogramentioning

confidence: 99%

High‐molecular weight IGF‐2 expression in a haemangiopericytoma associated with hypoglycaemia

Höög

Nordqvist

Hulting

et al. 1997

APMIS

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Spontaneous hypoglycaemia is usually caused by an insulin‐producing islet‐cell tumour of the pancreas. Rarely, it can be caused by non‐islet cell tumours. Most of the tumours are of mesenchymal type, large, and slowly growing. One representative is haemangiopericytoma (HAP). The present report describes a case of a large recurrent retroperitoneal HAP associated with severe hypoglycaemia. Blood serum insulin and proinsulin concentrations were low. By means of acid‐gel chromatography and dot‐blot techniques, an increased amount of a high‐molecular‐weight IGF‐2 peptide was found. By using antigen retrieval procedures, IGF‐2‐immunoreactive tumour cells were found in specimens of the recent tumour recurrence ‐ but not in the original. When the in situ hybridization technique was used it could be shown that IGF‐2 mRNA labelling had already occurred in the original tumour specimen, 11 years before the onset of hypoglycaemic symptoms. These observations confirm the hypothesized hypoglycaemic effects of high‐molecular‐weight (HMW) IGF‐2, but also point to the presence of a prolonged compensation of this effect. A literature review, based on 17 similar cases of haemangiopericytoma with hypoglycaemia, is presented. Our observation and findings in the literature review support the idea that non‐islet‐cell tumour hypoglycaemia is caused by an overproduction of a HMW IGF‐2 peptide. The insulin‐like effect is mediated via non‐specific binding to the insulin receptors. To anticipate patients at risk of developing this kind of hypoglycaemia, the histopathological investigation should include not only immunohistochemical analyses of the presence of IGF‐2 peptide, but also in situ hybridization of the IGF‐2 mRNA expression.

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Hemangiopericytoma associated with hypoglycemia

Cited by 72 publications

References 21 publications

Mediastinal Solitary Fibrous Tumor Diagnosed by Endobronchial Ultrasound-Directed Biopsy

Mediastinal Solitary Fibrous Tumor Diagnosed by Endobronchial Ultrasound-Directed Biopsy

Renal Hemangiopericytoma

High‐molecular weight IGF‐2 expression in a haemangiopericytoma associated with hypoglycaemia

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