IGF-II-secreting pelvic tumor presenting with neuropsychiatric symptoms

A 48-year-male presented with a gradually increasing lump in the abdomen, which was confirmed on investigations as a pelvic tumor. He developed frequent episodes of hypoglycemia and neuropsychiatric symptoms while awaiting surgery. During episodes of hypoglycemia, his serum C-peptide and insulin levels were negligible and the insulin-like growth factor (IGF)-II to IGF-I ratio was >10. He successfully underwent an en bloc excision of the tumor. Histopathology revealed a solitary fibrous tumor.