Primary Fibrosarcoma of the Liver With Hypoglycemia

Gen, Eisei; Kusuyama, Yoshio; Saito, Koji; Nagasaki, Yasuhiko; Nakatani, Toshihide; Yataka, Isao; Oku, Atsushi

doi:10.1111/j.1440-1827.1983.tb02111.x

Cited by 5 publications

(7 citation statements)

References 9 publications

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“…The development of the TAH syndrome is the product of the overall tumor burden and biological activity. Intractable hypoglycemia has been reported once before, in a patient who was deemed inoperable due to general deterioration and cachexia . In our patient, the TAH was also intractable, despite medical treatment.…”

Section: Discussionsupporting

confidence: 50%

“…TAH has been associated with both SFT 5,8-10 and fi brosarcoma of the liver. [12][13][14][15][16] PET scan in the present patient did not demonstrate any areas of hypermetabolism, and thus excessive utilization of glucose by the tumor 20 was not the mechanism of the hypoglycemia. The evidence in our molecular analysis supports the systemic effect of pro-IGF2, produced and secreted by the tumor, as the etiology.…”

Section: Discussionsupporting

confidence: 39%

“…TAH has been associated with both SFT, and fibrosarcoma of the liver . PET scan in the present patient did not demonstrate any areas of hypermetabolism, and thus excessive utilization of glucose by the tumor was not the mechanism of the hypoglycemia.…”

Section: Discussioncontrasting

confidence: 39%

“…11 Primary fi brosarcoma of the liver is also rare and has been associated with TAH. 12,13 A review of the literature found at least 17% of reported cases to be linked with hypoglycemia. 14,15 IGF2 has been identifi ed in the Golgi apparatus of fi brosarcoma cells in patients with elevated serum pro-IGF2 levels.…”

Section: Introductionmentioning

confidence: 99%

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Malignant transformation of a solitary fibrous tumor of the liver and intractable hypoglycemia

Chan

Horton

Thyssen

et al. 2007

J Hepatobiliary Pancreat Surg

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Sarcomas of the liver are rare. We report a case of intractable hypoglycemia secondary to a solitary fibrous tumor that underwent malignant transformation into a fibrosarcoma. A 70-year-old man presented with a hepatic mass and tumor-associated hypoglycemia which was resistant to medical management. Blood tests were remarkable only for elevated serum insulin-like growth factor (IGF)-2. The hypoglycemia resolved following resection of a solitary fibrous tumor surrounded by a high-grade fibrosarcoma. Real time reverse transcriptase polymerase chain reaction (RT-PCR) measured elevated levels of IGF2 mRNA in both the solitary fibrous tumor and the fibrosarcoma. Immunoblotting demonstrated a series of bands in the size range of pro-IGF2. Unfortunately, disseminated metastases developed 1 year later, concurrent with a recurrence of hypoglycemia, marked again by elevation of serum IGF2. Solitary fibrous tumors of the liver have a real risk of malignant transformation. The severity of the tumor-associated hypoglycemia may parallel the tumor burden and activity. The syndrome is the systemic effect of IGF2 secreted by the tumor. Surgery can treat the hypoglycemia syndrome and the underlying malignancy.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionsupporting

confidence: 39%

Section: Discussioncontrasting

confidence: 39%

Section: Introductionmentioning

confidence: 99%

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Malignant transformation of a solitary fibrous tumor of the liver and intractable hypoglycemia

Chan

Horton

Thyssen

et al. 2007

J Hepatobiliary Pancreat Surg

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“…Reports of patients with primary hepatic fibrosarcoma are rare, while 20% of these patients are associated with hypoglycemia as a paraneoplastic syndrome (1)(2)(3)(4)(5)(6). The insulin-like growth factor-II (IGF-II) produced by certain mesenchymal or epithelial tumors is thought to be responsible for the development of hypoglycemia in some cases (7,8).…”

Section: Introductionmentioning

confidence: 99%

IGF-II Producing Hepatic Fibrosarcoma Associated with Hypoglycemia.

et al. 1993

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A 67-year-old male was admitted with the complaint of weakness at hunger early in the morning, when blood glucose was less than 40 mg/dl. The abdominal ultrasonogram and computerized tomogram demonstrated a huge tumor in the right liver lobe. Hypoglycemia disappeared after transcatheter arterial embolization. Then hepatic lobectomy was performed. The tumor was histologically shown to be a fibrosarcoma. Insulin-like growth factor-II was intensely stained in the Golgi area of the tumor cells, suggesting its role in the mechanismof hypoglycemia. (Internal Medicine 32: 897-901, 1993)

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A case report of primary fibrosarcoma of the liver

et al. 1990

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A 75-year-old woman was admitted to our hospital complaining of right hypochondrial pain. Echo sonography and computed tomography demonstrated a large tumor with irregular internal density in the right lobe of the liver. Angiography revealed a moderately hypervascular tumor. She was treated with transcatheter arterial embolization. Three weeks later, the tumor ruptured. She died of accompanying acute myocardial infarction seven months after the onset of the illness. Autopsy revealed primary fibrosarcoma of the liver. The tumor appearance varied from firm whitish to soft myxomatous. A part of the tumor showed hemorrhagic necrosis. There was no intrahepatic metastasis. The tumor tissue was composed of spindle shaped cells and immunohistochemically stained with vimentin.

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Primary Fibrosarcoma of the Liver With Hypoglycemia

Abstract: An autopsy case of primary hepatic fibrosarcoma with severe hypoglycemia is reported. Only two cases have been previously reported. Histological features were well differentiated and partly indistinguishable from those of fibrous mesothelioma. ACTA PATHOL. JPN. 33 : 177-182, 1983.

Cited by 5 publications

References 9 publications

Malignant transformation of a solitary fibrous tumor of the liver and intractable hypoglycemia

Malignant transformation of a solitary fibrous tumor of the liver and intractable hypoglycemia

IGF-II Producing Hepatic Fibrosarcoma Associated with Hypoglycemia.

A case report of primary fibrosarcoma of the liver

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