Rhabdomyosarcoma of the Buttock Producing Hypoglycemia

Abstract

A 24-year old pregnant woman with profound hypoglycemia due to a bulky rhabdomyosarcoma of the buttock was initially treated by irradiation with shrinkage of the tumor and amelioration of hypoglycemic symptoms. Extended hemipelvectomy was subsequently performed and the patient died shortly after operation from uncontrolled hemorrhage. Including the case discussed herein, 84 cases of extrapancreatic neoplasms producing hypoglycemia have been reported in the world literature since 1930. These tumors originated from all 3 blastoderms usually presented in the peritoneal or thoracic cavities, but also in the gastro-intestinal tract and buttock, and manifested a wide spectrum of histologic types and malignant potential. The most likely mechanism of hypoglycemia appears to be production of an insulin-like substance and increased utilization of glucose by the tumor. The basic methods of diagnosis and treatment employed are outlined.