Two cases of large solitary fibrous tumors of the pleura associated with fasting hypoglycemia.

We describe two cases of elderly women who presented hypoglycemic episodes with suppressed levels of insulin and insulin-like growth factor I. They were found to have huge malignant solitary fibrous tumor of the pleura. The tumors had rich vascularization on enhanced CT scans and showed characteristic low signal intensity on T2-weighted MR images. This paraneoplastic hypoglycemia is caused by an incompletely processed precursor of insulin-like growth factor II secreted from the tumor. Hypoglycemia and insulin suppression were resolved after removal of the tumors.