MALIGNANT PHYLLODES TUMOR OF THE BREAST WITH HYPOGLYCEMIA - REPORT OFA CASE

A surgically resected case of giant malignant phyllodes tumor of the b reast associated with a hypoglycemic attack is reported. A 54-year-old woman was referred to our hospital with loss of consciousness and a h uge chest wall tumor. She was diagnosed as having a malignant phyllode s tumor by core needle biopsy and underwent palliative simple mastecto my because lung metastasis was detected on computed tomography and by other imaging modalities on admission. The preoperative laboratory dat a revealed a very low fasting blood sugar level of 37 mg/dl, After rem oval of the tumor, the blood sugar level gradually normalized (90-100 mg/dl) and the plasma insulin-like growth factor-ii (IGF-II) level pro mptly decreased, The IGF-II level of tumor extracts was high (2500 ng/ g wet weight) and the majority of atypical cells stained positively fo r IGF-II immunohistochemically. These findings suggested that the pati ent's hypoglycemia was associated with IGF-II produced by a giant mali gnant phyllodes tumor that consumed glucose.