Hypoglyceamia in a Patient with a Solitary Fibrous Tumour

OBJECTIVE: To illustrate an unusual mechanism causing hypoglycaemia. MATERIAL AND METHODS: A 76-year-old man presented with episodes of agitation and confusion and was resuscitated with oral glucose gel when found to be hypoglycaemic. RESULTS: A CT scan for an abdominal mass confirmed a solitary fibrous tumour (SFT). The sarcoma multidisciplinary team suggested conservative management. The patient’s episodic hypoglycaemia was managed with diet modification including corn-based starch, scheduled snacks and dexamethasone. Glucose levels were within normal range at discharge from hospital. The patient was referred to the palliative care team for follow-up. CONCLUSION: SFTs causing non-islet cell tumour hypoglycaemia are difficult to treat. LEARNING POINTS: To be aware of rarer causes of hypoglycaemia and to consider unusual causes in acute presentations of hypoglycaemia, especially in patients who do not have diabetes. This case illustrates the importance of a thorough general physical and systemic examination, as identifying the abdominal mass is essential to the early diagnosis of this rare condition. Solitary fibrous tumours causing non-islet cell tumour hypoglycaemia are difficult to treat, and even when surgical resections are applicable, recurrence rates are high.