SPONTANEOUS HYPOGLYCEMIA ASSOCIATED WITH FIBROGENIC TUMOR: REPORT OF TWO CASES

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Abstract
In 1 of 2 patients who had hypoglycemia in association with a fibrogenic tumor, surgical removal of a fibrosarcoma of the kidney apparently produced complete relief of symptoms. In a review of the clinical and pathologic data on these and 9 other cases reported in the literature, unusual features observed were that (1) the tumor was situated usually in the retro-peritoneal region but occasionally in the thorax, (2) the pancreas was not proved to be the site of origin in any of the cases, and (3) the tumors were of large size, ranging in weight from 770 g to 4720 g. The histo-logic characteristics of the tumors in the 2 cases reported herein are compared with those in 4 similar cases previously reported in the literature, and on the basis of these characteristics it is concluded that there is little hlstologic evidence to support the notion that these tumors are islet cell in origin; rather, the conventional interpretation of them as fibrogenic spindle cell neoplasms is favored. The possible mechanisms by which hypoglycemia may be produced in patients with fibrogenic tumors are discussed.

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