Hypoglycemia with a large retroperitoneal mass – Case report

• Retroperitoneal sarcomas have rarely been reported to secrete insulin-growth factor II (IGF-II) and lead to low blood glucose levels.
• Tumor-induced hypoglycemia should be considered in a patient with low blood glucose, low C-peptide, low fasting insulin levels and weight loss.
• Surgical resection should be a primary treatment modality for IGF-II-secreting tumors.

INTRODUCTIONRetroperitoneal sarcomas have rarely been reported to secrete insulin-growth factor II (IGF-II) and produce an enigmatic hypoglycemia. IGF-II-secreting sarcomas represent an extremely rare subset of soft tissue tumors, and reports are limited to a handful of cases.PRESENTATION OF CASEThe authors present the case of hypoglycemia due to an IGF-II-secreting retroperitoneal sarcoma that was successfully treated by complete surgical resection. This report describes the diagnosis and management of this rare syndrome with 1-year follow-up and a review of the literature.DISCUSSIONSteroid and growth hormone therapies also have efficacy to treat this hypoglycemia in some patients. However, outcomes appear better if combined with surgical resection.CONCLUSIONSThe findings of this case report and review of the literature support a primary role for complete tumor resection to address tumor-induced hypoglycemia.