Case of Benign Phyllodes Tumour Associated with Hypoglycemia

Summary of article contents:

Introduction

Phyllodes tumours of the breast are rare, accounting for less than 1% of all breast tumours, with the majority being benign. They typically manifest as solitary lumps in the breast, manifesting most often in pre-menopausal women but also seen occasionally in adolescents. Diagnosis relies on clinical examination, imaging studies, and fine-needle aspiration cytology. These tumours are often confused with fibroadenomas due to their similar appearances. Due to their potential for recurrence, complete surgical removal is generally recommended, along with regular follow-up for monitoring.

Hypoglycemia Associated with Phyllodes Tumour

A unique case highlighted involves a 20-year-old woman diagnosed with a significantly large benign phyllodes tumour of the left breast, approximately 34 cm in diameter. She experienced recurrent episodes of hypoglycemia, with her blood glucose dropping to critically low levels despite normal fasting insulin and C-peptide levels. Ultrasound scans ruled out insulinomas, leading to the conclusion that her hypoglycemia was possibly linked to the secretion of insulin-like growth factor II (IGF-II) from the tumour. Post-surgical removal of the tumour resulted in the full resolution of her hypoglycemic episodes, demonstrating a rare but significant connection between phyllodes tumours and hypoglycemic conditions due to elevated IGF levels.

Conclusion

This case underscores the importance of recognizing the atypical manifestations of benign phyllodes tumours, such as recurrent hypoglycemia. The relationship between tumour size, IGF secretion, and hypoglycemia is crucial for clinicians to consider in diagnosing and managing patients with these rare breast neoplasms. Surgical intervention not only proved beneficial in resolving the patient's symptoms but also reinforces the necessity for comprehensive evaluation and monitoring of the effects these tumours may have on metabolic functions.