Hypoglycemia with a large retroperitoneal mass – Case report

INTRODUCTION: Retroperitoneal 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 CASE: The 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. DISCUSSION: Steroid and growth hormone therapies also have efficacy to treat this hypoglycemia in some patients. However, outcomes appear better if combined with surgical resection. CONCLUSIONS: The findings of this case report and review of the literature support a primary role for complete tumor resection to address tumor-induced hypoglycemia.