乳房葉狀瘤(phyllodes tumor) 好發在40-50 歲女性，細胞起源於乳腺間質組織，亦含有乳管上皮組織。依病理細胞型態可區分良性、邊緣惡性(borderline)及惡性。腫瘤超過十公分就有惡性的可能，高度惡性乳房葉狀瘤約1/3 案例在初診斷時既已發現遠端轉移，常見轉移部位以肺、骨骼、肝臟及腦部為主。非胰島細胞腫瘤性低血糖(non-islet cell tumor hypoglycemia;NICTH) 泛指由胰島細胞腫瘤以外的其他腫瘤引起的低血糖症。乳房葉狀瘤導致NICTH極為罕見。乳房葉狀瘤是否造成NICTH以及局部復發的可能性跟葉狀瘤的細胞型態無關。治療的方式為全腫瘤切除，且手術邊緣保留至少一公分。我們分享一位無糖尿病病史的41 歲女性有巨大乳房腫瘤且在有含糖點滴滴注下仍反覆低血糖，給予類固醇才緩解低血糖，手術切除腫瘤之後低血糖可不藥而癒，靠排除法等間接證據診斷為NICTH的案例。

Phyllodes tumors (PTs) are an uncommon fibroepithelial tumor composed of a cellular stromal and an epithelial component. Occurrence is most common between the ages of 40 and 50 in females, prior to menopause. They may be benign, borderline, or malignant depending on histologic features. PTs with potentially malignant of distant metastasis to lung, bone, liver and brain, generally greater than 10 cm in diameter. Non-islet cell tumor hypoglycemia (NICTH) is a paraneoplastic process, and its hypoglycemia caused by tumors other than islet cell tumors. PT-induced NICTH is extremely rare. Neither the possibility of local recurrence nor the incidence of PT-induced hypoglycemia is related to its histologic grade. The standard treatment is wide local excision and surgical margin greater than 1 cm. Here, we present a challenging case of a non-diabetic, 41-year-old woman suffered from refractory hypoglycemia, even under continuous infusion of dextrose. She is diagnosed with PT-induced NICTH by the fact that hypoglycemia subsided under glucocorticoid and cured after tumor removed.