[Solitary Fibrous Tumor: a Rare Cause of Recurrent Severe Hypoglycemia]. / Solitär fibröser Tumor: eine seltene Ursache rezidivierender schwerer Hypoglykämien.

HISTORY AND CLINICAL FINDINGS: A 73-year-old woman was admitted to hospital early in the morning by an emergency doctor in initially unclear comatose conditions with a blood glucose of 24 mg/dl. There were no important previous diseases requiring any medication. She was in good physical state. EXAMINATIONS: Except for a lowered breath sound on the right side of the chest the physical findings were normal. Endocrinologic tests, diagnostic imaging (Chest-x-ray, ultrasonography of abdomen and pleura, abdominal and thoracic CT) and fine needle biopsy suggested a non-islet-cell-tumor on the right side of the pleura as cause of hypoglycemia. TREATMENT: Resection of the tumor resulted in normoglycemia and the pathologic examination of the tumor specimen revealed a solid fibrous tumor. CONCLUSION: A solid fibrous tumor is a relatively common cause of the rare syndrome of non-islet-cell-tumor hypoglycemia. It shows typical endocrinologic findings, which immediately help to clarify the differential diagnosis with other causes of severe hypoglycemia. Early thorough endocrinologic testing is therefore paramount for the recognition of this distinct hypoglycemic disease which is related to the release of IGF-2, respectively Big-IGF-2, from the tumor cells.