In Lviv, a 25-centimeter tumor was removed from a patient in a coma
In Lviv, doctors saved 77-year-old Stepan Rebets, who was diagnosed with an extremely rare liver tumor measuring 25×17 centimeters. Due to the tumor’s hormonal activity, the man’s body was losing sugar, and the patient himself fell into a hypoglycemic coma due to critically low glucose levels.
This unique case occurred at St. Panteleimon Hospital, which is part of Lviv’s First Medical Association.
At 77 years old, Stepan Rebets continued to work actively on his farm. However, recently he began to feel severe weakness and suspected that diabetes might be the cause.
An emergency medical team transported him to St. Panteleimon Hospital. The patient was found to have critically low blood sugar, after which he fell into a hypoglycemic coma.
During a CT scan, doctors discovered a massive tumor in the central part of the upper half of the abdominal cavity—measuring 25×17 centimeters.
Daniil Plakhtina, a surgeon at St. Panteleimon Hospital, explained that doctors initially suspected the tumor originated in the pancreas.
“At first, we assumed that the tumor might originate in the pancreas. After all, a sharp and sustained drop in blood glucose levels is characteristic, in particular, of insulinomas—pancreatic tumors that produce insulin. At the same time, insulinomas are usually very small, whereas in this patient, the tumor measured 25 cm,” the doctor explained.
Further examination revealed that the tumor originated from connective tissue and received its blood supply from the hepatic arteries.
As a result, the doctors made an accurate diagnosis: a solitary fibrous tumor of the liver.
A solitary fibrous tumor is an extremely rare benign tumor. According to doctors, it is diagnosed in only 1–3 people per million each year.
However, Stepan Rebets’ case was particularly unusual for several reasons.
First, the tumor’s location was unusual. In approximately 90% of cases, such tumors arise in the chest cavity—from the connective tissue of the pleura. Liver involvement is extremely rare.
Second, the tumor was enormous—25 centimeters in size. Typically, such tumors are detected much earlier due to pressure on neighboring organs.
Third, the tumor was hormonally active. In fewer than 5% of patients with a solitary fibroid tumor, the growth produces an insulin-like substance that helps lower blood sugar levels.
To prepare the patient for the complex surgical procedure, the medical team first performed embolization of the artery supplying the tumor.
Interventional radiologists performed the procedure via a vascular puncture. This reduced blood flow to the tumor and stabilized the man’s condition.
Just four days later, surgeons moved on to the second stage of treatment and successfully removed the giant tumor.
After the surgery, Stepan Rebets’ blood sugar levels returned to normal.
Following treatment, the man is feeling well and is already planning to return to his normal life.
“I feel good. I still want to drive my tractor around because I don’t like sitting around doing nothing,” said Stepan Rebets.
The patient thanked the medical staff for saving his life, and the doctors note that this case is exceptional due to the tumor’s rare location, its size, and its ability to affect glucose levels in the body.
This was reported by the First Medical Association of Lviv.
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