Endocrinol Metab > Volume 22(6); 2007 > Article
Journal of Korean Endocrine Society 2007;22(6):440-445.
DOI: https://doi.org/10.3803/jkes.2007.22.6.440    Published online December 1, 2007.
A Case of Epithelioid Hemangioendothelioma of the Pelvic Retroperitoneum with Hypoglycemia.
Ji Ryang Kim, Yun Kyung Jeun, Kee Tae Park, Yang Ho Kang, Seok Man Son, In Ju Kim, Yong Ki Kim, Kyung Un Choi, Kwang Jae Lee
1Department of Internal Medicine, School of Medicine, Pusan National University, Korea.
2Department of Pathology, School of Medicine, Pusan National University, Korea.
3Department of Internal Medicine, Dae-Dong Hospital, Korea.
Hypoglycemia caused by a non-islet cell tumor (NICT) is a rare condition. The mechanism of NICT-induced hypoglycemia is still unclear, but insulin-like growth factor-II (IGF-II) has been thought to play a major role in its development. NICT is usually of mesenchymal or epithelial cell origin, but reports on NICT of an endothelial cell origin, which causes hypoglycemia, have yet to surface. Here, we report on a case of a 63-year-old female patient who was diagnosed with epithelioid hemangioendothelioma-induced hypoglycemia. Epithelioid hemangioendothelioma is a borderline malignant vascular tumor that is of endothelial cell origin and usually occurs in soft tissue, skin, lung, and liver. It was observed that serum insulin, C-peptide, and IGF-I were reduced, but the IGF-II level was elevated in hypoglycemia. The PET-CT showed no abnormal glucose metabolism in the tumor. Dextrose fluid was administered to the patient to control hypoglycemia until the operation. For treatment and diagnosis, surgical resection of the tumor and total hysterectomy were performed. The specimen was noted to have epithelioid hemangioendothelioma. Hypoglycemia-related symptoms disappeared after surgical resection was performed.
Key Words: epithelioid hemangioendothelioma, hypoglycemia, insulin-like growth factor-II

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