Background: Solitary fibrous tumor (SFT) is a rare fibroblastic mesenchymal tumor. It can originate from abdominal soft tissue which is extremely scarce, and liver indeed is super scant site. SFT liver (SFTL) is mostly benign, but it can be malignant and aggressive with metastases and a potential of recurrence. Hypoglycemia is the least reported feature which is resistant to medical management and will be resolved following resection of a SFT of liver.Case Report: A 67-year-old man presented with episodes of sudden onset loss of consciousness since 3 months before first visit. He was a previously healthy farmer, without any other complaint or past medical history except for episodes of sever hypoglycemia. Laboratory testing revealed hypoglycemia which was temporarily response to glucose infusion, hypoglycemia was refractive, and whole physical examination and laboratory tests were done and there were no abnormal findings. With probability of finding something such as insulinoma or any other tumor that secreted insulin or insulin-like growth factors, a magnetic resonance imaging (MRI) was performed and revealed an enhancing giant round and well-defined lesion in left lobe of live.Conclusions: We here present the first case of malignant SFTL presenting with hypoglycemia and metastasis to soft tissue as inguinal bulging 2 months after resection of liver mass, but this particular type of tumor needs more evaluation and investigation
