高分子 insulin-like growth factor-II 産生性孤立性線維性腫瘍の1例  [in Japanese] A case of solitary fibrous tumor producing high molecular weight insulin-like growth factor-II  [in Japanese]

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Author(s)

    • 原田 亜矢 HARADA Aya
    • 鹿児島大学大学院医歯学総合研究科呼吸器外科学分野 Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
    • 中村 好宏 NAKAMURA Yoshihiro
    • 鹿児島大学大学院医歯学総合研究科呼吸器外科学分野 Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
    • 永田 俊行 NAGATA Toshiyuki
    • 鹿児島大学大学院医歯学総合研究科呼吸器外科学分野 Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
    • 大塚 綱志 OTSUKA Tsunayuki
    • 鹿児島大学大学院医歯学総合研究科呼吸器外科学分野 Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
    • 酒瀬川 浩一 SAKASEGAWA Koichi
    • 鹿児島大学大学院医歯学総合研究科呼吸器外科学分野 Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
    • 佐藤 雅美 SATO Masami
    • 鹿児島大学大学院医歯学総合研究科呼吸器外科学分野 Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University

Abstract

低血糖発作を契機に孤立性線維性腫瘍(solitary fibrous tumor:SFT)が発見され,手術で軽快した1例を経験したので報告する.症例は54歳の女性.朝起床時に意識消失発作と言語障害があり,精査で低血糖と左胸腔内に最大径23×14×9 cmの腫瘤を認め,CTガイド下針生検でSFTと診断された.血中インスリン,C-ペプチドは低下し,下垂体と副腎機能は基準値内であり,低血糖は腫瘍随伴症状と考えられ,腫瘍摘出術を行った.術後,血糖値は安定した.また術前の採血検体から高分子のインスリン様成長因子-II(insulin-like growth factor - II:IGF-II)が検出され,免疫染色でIGF-II陽性であったことから,低血糖はSFTが産生した高分子IGF-IIによるものと考えられた.術後1年経過時点で低血糖症状や再発徴候は認めていない.

We report a case of a solitary fibrous tumor (SFT) associated with hypoglycemia. A 54-year-old woman experienced loss of consciousness and dysarthria when awakening. On an investigation, hypoglycemia and a huge intrathoracic mass were detected, which was diagnosed as SFT by needle biopsy. Other endocrinological investigations were normal except for low values of immunoreactive insulin and C-peptide. Since the symptoms were suspected to be related to the tumor, she underwent complete resection of the tumor. After the operation, all symptoms disappeared, and insulin-like growth factor II (IGF-II) was stained positive by immunohistochemistry. High molecular weight IGF-II was also detected from a preoperative blood sample. We propose that high molecular weight IGF-II produced by SFT caused the hypoglycemia. There have been no signs of recurrence for one year since the operation.

Journal

  • The Journal of the Japanese Association for Chest Surgery

    The Journal of the Japanese Association for Chest Surgery 26(5), 536-541, 2012-07-15

    The Japanese Association for Chest Surgery

References:  21

Codes

  • NII Article ID (NAID)
    10030500975
  • NII NACSIS-CAT ID (NCID)
    AN10467885
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    09190945
  • Data Source
    CJP  J-STAGE 
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