Intraoperative glycemic control using an artificial endocrine pancreas in a patient with a recurrent pleural solitary fibrous tumor producing insulin-like growth factor 2: a case report

BACKGROUND: Non-islet cell tumor producing insulin-like growth factor 2 involves hypoglycemia. During tumor resection, intense fluctuation of blood glucose level may occur. An artificial endocrine pancreas has been reported as beneficial for patients with insulinoma as it maintains stable glycemic levels, although scarcely described with insulin-like growth factor 2-releasing tumor. CASE PRESENTATION: An 84-year-old man had a recurrent left pleural solitary fibrous tumor releasing high molecular weight insulin-like growth factor 2 and experienced a frequent syncope accompanied by hypoglycemia. After anesthesia induction, an artificial endocrine pancreas, STG-55, was connected to the patient. Blood glucose level was stable at around 150 mg/dl during the resection surgery. The patient followed an uneventful course and was discharged without any complications. CONCLUSIONS: An artificial endocrine pancreas may have the potential to stabilize the intraoperative blood glucose change in insulin-like growth factor 2-releasing tumor resection.