F. Fallahian1,4, A. Ardestani1, C. Raut1,2,3, A. Tavakkoli1,2, E. Sheu1,2 1Brigham And Women’s Hospital,Boston, MA, USA 2Harvard Medical School,Boston, MA, USA 3Dana Farber Cancer Insititute,Boston, MA, USA 4University Of Missouri-Kansas City School Of Medicine,Kansas City, MO, USA
Introduction: The metabolic and immunologic properties of adipose tissue are linked to the pathogenesis of type 2 diabetes mellitus. Lipomatous tumors, such as liposarcomas, are rare but can reach significant size. We hypothesized that some lipomatous tumors are metabolically active and can alter systemic glucose homeostasis.
Methods: We performed a retrospective study of patients who underwent surgical excision of a lipomatous tumor at a tertiary cancer referral center (2004-2015). We divided patients into non-diabetics, well-controlled diabetics (HbA1c < 7), and poorly-controlled diabetics (HbA1c ≥ 7). We compared patient demographics, tumor characteristics, and measures of glycemic control among these groups both before and after tumor resection.
Results: 203 patients underwent 235 operations for lipomatous tumors. No differences were observed in tumor characteristics in patients with and without diabetes. However, tumor characteristics differed significantly between the well-controlled and poorly-controlled diabetics (Table 1). Patients with poorly-controlled diabetes had larger tumors that were more likely to be malignant and well-differentiated. Interestingly, we identified seven patients whose diabetes significantly improved with tumor resection. Overall, in the poorly-controlled diabetic group, there was a significant improvement in random blood glucose (109 mg/dL vs. 176 mg/dL, p < 0.05), without an associated change in BMI or number of diabetes medications, following tumor resection.
Conclusion: Development of a lipomatous tumor alone does not lead to diabetes. There was an association, however, between larger, malignant tumors and poorly-controlled diabetes. In a subset of patients, tumor resection improved glycemic control, suggesting that selected lipomatous tumors may be metabolically active.
