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Schöler F, Storz MA, Khavaran A, Hümmler N, Russe MF, Wielenberg C, Laubner K, Seufert J. Effective management of recurrent Doege-Potter syndrome with somatostatin-analogues: A case report. Cancer Rep (Hoboken) 2024; 7:e1992. [PMID: 38441351 PMCID: PMC10913086 DOI: 10.1002/cnr2.1992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 12/10/2023] [Accepted: 01/15/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Doege-Potter syndrome is defined as paraneoplastic hypoinsulinemic hypoglycemia associated with a benign or malignant solitary fibrous tumor frequently located in pleural, but also extrapleural sites. Hypoglycemia can be attributed to paraneoplastic secretion of "Big-IGF-II," a precursor of Insulin-like growth factor-II. This prohormone aberrantly binds to and activates insulin receptors, with consecutive initiation of common insulin actions such as inhibition of gluconeogenesis, activation of glycolysis and stimulation of cellular glucose uptake culminating in recurrent tumor-induced hypoglycemic episodes. Complete tumor resection or debulking surgery is considered the most promising treatment for DPS. CASE Here, we report a rare case of a recurrent Doege-Poter Syndrome with atypical gelatinous tumor lesions of the lung, pleura and pericardial fat tissue in an 87-year-old woman. Although previously described as ineffective, we propose that adjuvant treatment with Octreotide in conjunction with intravenous glucose helped to maintain tolerable blood glucose levels before tumor resection. The somatostatin-analogue Lanreotide was successfully used after tumor debulking surgery (R2-resection) to maintain adequate blood glucose control. CONCLUSION We conclude that somatostatin-analogues bear the potential of being effective in conjunction with limited surgical approaches for the treatment of hypoglycemia in recurrent or non-totally resectable SFT entities underlying DPS.
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Affiliation(s)
- Felix Schöler
- Division of Endocrinology and Diabetology, Department of Internal Medicine II, University Hospital of Freiburg, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Maximilian Andreas Storz
- Division of Endocrinology and Diabetology, Department of Internal Medicine II, University Hospital of Freiburg, Faculty of MedicineUniversity of FreiburgFreiburgGermany
- Department of Internal Medicine II, Center for Complementary Medicine, University Hospital of Freiburg, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Ashkan Khavaran
- Division of Endocrinology and Diabetology, Department of Internal Medicine II, University Hospital of Freiburg, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Nicolas Hümmler
- Department of Thoracic Surgery, Medical CenterUniversity Hospital of FreiburgFreiburgGermany
| | - Maximilian Frederik Russe
- Department of Radiology, Clinic for Diagnostic and Interventional Radiology, University Hospital of Freiburg, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | | | - Katharina Laubner
- Division of Endocrinology and Diabetology, Department of Internal Medicine II, University Hospital of Freiburg, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Jochen Seufert
- Division of Endocrinology and Diabetology, Department of Internal Medicine II, University Hospital of Freiburg, Faculty of MedicineUniversity of FreiburgFreiburgGermany
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Sheikh K, Mody A, Haynes AB, Kumar P. Doege-Potter Syndrome: A Solitary Fibrous Tumor Causing Non-Islet Cell Tumor Hypoglycemia. JCEM Case Rep 2024; 2:luae017. [PMID: 38405103 PMCID: PMC10886439 DOI: 10.1210/jcemcr/luae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Indexed: 02/27/2024]
Abstract
Doege-Potter syndrome occurs when incompletely processed insulin-like growth factor 2 (IGF-2), also known as big IGF-2, is produced by a solitary fibrous tumor (SFT) and results in non-islet cell tumor hypoglycemia (NICTH). We discuss here the case of a 66-year-old male who presented with a 2-week history of increasing confusion and a serum glucose of 34 mg/dL. The patient's symptoms immediately improved with dextrose. The patient did not use insulin, serum sulfonylurea screen was negative, and testing for adrenal insufficiency was unremarkable. Outpatient laboratory evaluation revealed a serum glucose of 48 mg/dL along with low insulin, C-peptide, and proinsulin levels. Further work-up showed an IGF-2 to IGF-1 ratio of 38:1. A ratio greater than 10:1 is diagnostic of NICTH. Imaging demonstrated a 21-cm mass in the lower abdomen and pelvis. The patient underwent surgical resection. The hypoglycemia resolved immediately postoperatively. Surgical pathology revealed a malignant SFT. In NICTH, big IGF-2 forms a complex that is biologically active and saturates the insulin and IGF receptors, resulting in refractory hypoglycemia. Although glucocorticoids can mitigate hypoglycemia, complete surgical resection is the only definitive treatment of NICTH. This case highlights the importance of maintaining a broad differential for seemingly simple hypoglycemia.
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Affiliation(s)
- Khalid Sheikh
- Department of Internal Medicine, Dell Medical School at the University of Texas at Austin, Austin, TX 78712, USA
| | - Avni Mody
- Department of Internal Medicine, Division of Endocrinology, Dell Medical School at the University of Texas at Austin, Austin, TX 78712, USA
| | - Alex B Haynes
- Department of Surgery and Perioperative Care and Department of Oncology, Dell Medical School at the University of Texas at Austin, Austin, TX 78712, USA
| | - Pratima Kumar
- Department of Internal Medicine, Division of Endocrinology, Dell Medical School at the University of Texas at Austin, Austin, TX 78712, USA
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3
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Wang C, Cao T, Hu G, Min B, Hu H, Liu B, Wang Y, Zuo X. Recurrence of solitary fibrous tumor of the pleura with hypoglycemia ( Doege-Potter Syndrome): a case report description. Front Oncol 2023; 13:1245289. [PMID: 37823058 PMCID: PMC10562620 DOI: 10.3389/fonc.2023.1245289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
Hypoglycemia has multiple causes, but the most common is a complication of insulin treatment. In addition to insulin therapy, tumors such as insulinomas of pancreatic origin and extrapancreatic tumors causing paraneoplastic syndromes should also be considered. Solitary fibrous tumors of the pleura (SFTP) is rare tumor, which when associated with hypoglycemia causes Doege-Potter syndrome. This article reports a case of a 69-year-old man with Doege-Potter syndrome and underwent the first surgical resection for SFTP. However, the tumor recurred 9 years later with hypoglycemic symptoms and implant metastasis. This recurrent tumor originated from the visceral pleura, was more aggressive and invaded the diaphragm and parietal pleura. After the second surgical removal of the tumor, the hypoglycemic symptoms disappeared.
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Affiliation(s)
- Chuxu Wang
- Department of Thoracic Surgery, Huai’an Second People’s Hospital, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, China
| | - Tingting Cao
- Department of Thoracic Surgery, Huai’an Second People’s Hospital, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, China
| | - Guodong Hu
- Department of Thoracic Surgery, Huai’an Second People’s Hospital, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, China
| | - Bo Min
- Department of Thoracic Surgery, Huai’an Second People’s Hospital, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, China
| | - Haibo Hu
- Department of Thoracic Surgery, Huai’an Second People’s Hospital, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, China
| | - Bing Liu
- Department of Thoracic Surgery, Huai’an Second People’s Hospital, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, China
| | - Yaqin Wang
- Department of Thoracic Surgery, Huai’an Second People’s Hospital, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, China
| | - Xiaohua Zuo
- Department of Pain Management, Huai’an Second People’s Hospital, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, China
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4
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Corsano C, Paradiso M, Laudadio ED, Sollitto F, Lamacchia O. A Case Report of Doege-Potter Syndrome: A Rare Cause of Hypoglycemia in a Patient without Diabetes. J Clin Med 2023; 12:3984. [PMID: 37373678 DOI: 10.3390/jcm12123984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Hypoglycemia in patients without diabetes is a diagnostic challenge for the endocrinologist. Sometimes it is related to rare causes such as Doege-Potter Syndrome (DPS). DPS is caused by an abnormal insulin-like grow factor 2(IGF-2) that retains part of the E domain during the production process, resulting in a longer peptide called "big-IGF-2". We present a case report of DPS with emphasis on the diagnosis and especially on the difficulties in interpreting the biochemical findings. An elderly patient with an intrathoracic neoplasm and hypoglycemia underwent various tests: insulin autoantibodies and fasting test were both negative. She had low values of IGF-1 and normal values of IGF-2 that apparently excludes a diagnosis of DPS. The evaluation of the IGF-2/IGF-1 ratio is the most important test because a ratio >10 is widely considered to be indicative of non-islet cell tumor hypoglycemia (NICTH). Glucose infusion and steroid therapy were used to control the hypoglycemia, but the definitive treatment was surgery, which almost immediately reversed the hypoglycemia. The differential diagnosis of hypoglycemia should include rare causes such as DPS, and the IGF-2/IGF-1 ratio is a useful tool.
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Affiliation(s)
- Chiara Corsano
- Endocrinology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Matteo Paradiso
- Endocrinology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Ester Daniela Laudadio
- Endocrinology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Francesco Sollitto
- Institute of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Olga Lamacchia
- Endocrinology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
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Rötgens J, Lapauw B, T'Sjoen G. Doege-Potter syndrome in a patient with a giant abdominal solitary fibrous tumor: a case report and review of the literature. Acta Clin Belg 2023:1-7. [PMID: 36641633 DOI: 10.1080/17843286.2023.2165652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
A 63-year-old man with spells of reduced consciousness in the morning and a giant abdominal mass presented to our institution for a second opinion. Investigation revealed non-diabetic hypoinsulinemic hypoglycemic events. Removal of the abdominal mass solved the hypoglycemia. Anatomopathological examination confirmed a solitary fibrous tumor (SFT). Doege-Potter syndrome was diagnosed. Doege-Potter syndrome is a potentially life-threatening rare paraneoplastic syndrome characterized by recurrent hypoinsulinemic hypoglycemia due to the overproduction of a prohormone form of insulin-like growth factor-II (pro-IGF-II) from a solitary fibrous tumor. First, we describe the clinical, laboratory and radiologic findings of the case. Second, a brief literature review on Doege-Potter syndrome is provided.
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Affiliation(s)
- Joris Rötgens
- Department of Endocrinology, Ghent University Hospital, Belgium
| | - Bruno Lapauw
- Department of Endocrinology, Ghent University Hospital, Belgium
| | - Guy T'Sjoen
- Department of Endocrinology, Ghent University Hospital, Belgium
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6
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Abstract
We present the case of a 71-year-old man with a history of type 2 diabetes mellitus manifesting abdominal pain, weight loss, dyspnea on small efforts, muscle weakness, and left subcostal swelling. Associated with this, he developed frequent episodes of syncope, diaphoresis, and night sweats, during which blood glucose levels below 50 mg/dL and improvement were documented after the administration of hypercaloric beverages or intravenous dextrose. Abdominal computed tomography revealed the presence of a tumor of approximately 20 cm dependent on the left adrenal gland. Histopathological diagnosis of a solitary retroperitoneal fibrous tumor was obtained, confirmed by immunohistochemistry.
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Affiliation(s)
- Joaquín D Campista-Jácquez
- Servicio Social. Hospital Ángeles Chihuahua, Chihuahua, Chihuahua, México.,Departamento de Cirugía General. Hospital Ángeles Chihuahua, Chihuahua, Chihuahua, México
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7
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Zarra VL, Demegillo KJ, Uyking-Naranjo M, Domado A. Doege-Potter Syndrome: A Presumptive Case of Metastatic Hemangiopericytoma with Persistent Hypoglycemia in a 27-Year-Old Male. J ASEAN Fed Endocr Soc 2021; 36:90-4. [PMID: 34177094 DOI: 10.15605/jafes.036.01.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 02/28/2021] [Indexed: 11/17/2022] Open
Abstract
Doege-Potter syndrome (DPS) is a rare paraneoplastic condition characterized by hypoinsulinemic hypoglycemia from a solitary fibrous tumor. The underlying mechanism is the secretion of a prohormone form of insulin-like growth factor II (IGF-II) by the tumor, which causes decreased release of glucose into the circulation. We report the case of a 27-year-old Filipino male with presumptive DPS from a recurrent right temporo-zygomatic hemangiopericytoma (HPC). The complexity of DPS requires a multidisciplinary approach. Early screening for metastases from HPC may prevent the undesirable sequelae of the disease process.
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Mohammed T, Ozcan G, Siddique AS, Araneta Iii RN, Slater DE, Khan A. Doege-Potter Syndrome with a Benign Solitary Fibrous Tumor: A Case Report and Literature Review. Case Rep Oncol 2021; 14:470-476. [PMID: 33976622 PMCID: PMC8077665 DOI: 10.1159/000512823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/27/2022] Open
Abstract
Doege-Potter syndrome is a rare paraneoplastic syndrome that is often diagnosed incidentally during the workup of hypoglycemia of unclear etiology. It is characterized by a non-islet cell tumor hypoglycemia secondary to excessive production of partially processed IGF-II hormone from a solitary fibrous tumor (SFT). Often these tumors are intrathoracic, benign, and asymptomatic. Occasionally they present as a paraneoplastic event; hypertrophic osteoarthropathy in Pierre-Marie-Bamberger syndrome and hypoglycemia in Doege-Potter syndrome. The NAB2-STAT6 gene fusion is the hallmark of the SFT. Complete surgical resection of the tumor often results in resolution of symptoms and cure in most cases. Here we present the case of an 83-year-old non-diabetic female with recurrent syncopal events who was diagnosed with the Doege-Potter syndrome secondary to a SFT of pleura. Her tumor was positive for NAB2-STAT6 gene fusion on RT-PCR. Following the resection of the giant tumor mass, she became symptom-free within 24 h, and has remained asymptomatic at 4 months follow-up.
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Affiliation(s)
- Turab Mohammed
- Department of Internal Medicine, University of Connecticut, Farmington, Connecticut, USA
| | - Gonca Ozcan
- Department of Internal Medicine, University of Connecticut, Farmington, Connecticut, USA
| | - Ayesha S Siddique
- Department of Pathology, Hartford Hospital, Hartford, Connecticut, USA
| | | | - Dennis E Slater
- Department of Hematology-Oncology, Hartford Hospital, Hartford, Connecticut, USA
| | - Aziz Khan
- Department of Internal Medicine, University of Connecticut, Farmington, Connecticut, USA
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9
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Geng H, Ye Y, Jin Y, Li BZ, Yu YQ, Feng YY, Li JT. Malignant solitary fibrous tumor of the pancreas with systemic metastasis: A case report and review of the literature. World J Clin Cases 2020; 8:343-352. [PMID: 32047784 PMCID: PMC7000951 DOI: 10.12998/wjcc.v8.i2.343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/18/2019] [Accepted: 12/22/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pancreatic solitary fibrous tumor (SFT) is a rare neoplasm of intermediate biological potential. So far, only 22 cases have been reported since 1999. All the cases, except one, exhibited benign features. Here, we report the first case of malignant pancreatic SFT with typical Doege-Potter syndrome, along with the clinical and pathologic evidence of its systemic metastasis.
CASE SUMMARY The patient was a 48-year-old man with a 1-year history of pancreatic and liver masses and refractory hypoglycemia. Increased uptake of the tracer fluorodeoxyglucose (FDG) was found in the liver and bones by fluorine-18 FDG positron emission tomography/computed tomography. After multidisciplinary discussion, a distal pancreatectomy procedure was performed, and histological examination showed a lesion composed of abundant heterogeneous spindle cells with localized necrosis. On immunohistochemistry evaluation, STAT6 was found to be diffusely expressed in the tumor. Based on the overall evidence, the patient was diagnosed with malignant pancreatic SFT with liver and bone metastases.
CONCLUSION The diagnosis of malignant SFT requires comprehensive evidence including clinical, immunohistochemistry, and histological features. This case may be presented as a reference for diagnoses and management of malignant pancreatic SFTs with systemic metastasis.
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Affiliation(s)
- Hao Geng
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Yu Ye
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Yun Jin
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Bai-Zhou Li
- Department of Pathology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Yuan-Quan Yu
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Yang-Yang Feng
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Jiang-Tao Li
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
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Delvecchio A, Duda L, Conticchio M, Fiore F, Lafranceschina S, Riccelli U, Cristofano A, Pascazio B, Colagrande A, Resta L, Memeo R. Doege-Potter syndrome by malignant solitary fibrous tumor of the liver: A case report and review of literature. World J Gastrointest Surg 2019; 11:348-357. [PMID: 31523385 PMCID: PMC6715584 DOI: 10.4240/wjgs.v11.i8.348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/09/2019] [Accepted: 08/13/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Solitary fibrous tumor of the liver (SFTL) is a rare occurrence with a low number of cases reported in literature. SFTL is usually benign but, 10%-20% cases are reported to be malignant with a tendency to metastasize. The majority of malignant SFTL cases are associated with a paraneoplastic hypoglycaemia defined as Doege-Potter syndrome. Surgery is the best therapeutic treatment, however, long- life follow-up is recommended.
CASE SUMMARY A 74-year-old man, was admitted to the emergency department after a syncopal episode with detection of hypoglycaemia resistant to medical treatment. The computed tomography revealed a solid mass measuring 15 cm of the left liver. An open left hepatectomy was performed with complete resection of tumor. Histopathological analyses confirmed a malignant SFTL.
CONCLUSION Large series with long-term follow-up have not been published neither have clinical trials been undertaken. Consequently, the methodical long-term follow-up of surgically treated SFTLs is strongly recommended.
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Affiliation(s)
- Antonella Delvecchio
- Department of Emergency and Organ Transplantation, General Surgery Unit “M. Rubino”, University of Bari, Bari 70124, Italy
| | - Loren Duda
- Department of Pathology, University of Bari, Bari 70124, Italy
| | - Maria Conticchio
- Department of Emergency and Organ Transplantation, General Surgery Unit “M. Rubino”, University of Bari, Bari 70124, Italy
| | - Felicia Fiore
- Department of Emergency and Organ Transplantation, General Surgery Unit “M. Rubino”, University of Bari, Bari 70124, Italy
| | - Stefano Lafranceschina
- Department of Emergency and Organ Transplantation, General Surgery Unit “M. Rubino”, University of Bari, Bari 70124, Italy
| | - Umberto Riccelli
- Department of Emergency and Organ Transplantation, General Surgery Unit “M. Rubino”, University of Bari, Bari 70124, Italy
| | - Antonella Cristofano
- Department of Oncology, Ente Ecclesiastico Ospedale F. Miulli, Acquaviva delle Fonti 70021, Italy
| | - Bianca Pascazio
- Department of General Surgery, Ospedale San Paolo, Bari 70123, Italy
| | - Anna Colagrande
- Department of Pathology, University of Bari, Bari 70124, Italy
| | - Leonardo Resta
- Department of Pathology, University of Bari, Bari 70124, Italy
| | - Riccardo Memeo
- Department of Emergency and Organ Transplantation, General Surgery Unit “M. Rubino”, University of Bari, Bari 70124, Italy
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García-Amador C, De La Plaza Llamas R, Ramia Ángel JM, Guerra Requena M, Arteaga Peralta V, Valenzuela Torres J. Pelvic Solitary Fibrous Tumor. J Gastrointest Surg 2018; 22:1448-1449. [PMID: 29255957 DOI: 10.1007/s11605-017-3651-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/01/2017] [Indexed: 01/31/2023]
Affiliation(s)
- Cristina García-Amador
- Department of General Surgery of Guadalajara University Hospital, 19002, Guadalajara, Spain.
| | - Roberto De La Plaza Llamas
- Department of General Surgery of Guadalajara University Hospital, 19002, Guadalajara, Spain.,Alcalá de Henares University, 28871, Alcalá de Henares, Spain
| | - José Manuel Ramia Ángel
- Department of General Surgery of Guadalajara University Hospital, 19002, Guadalajara, Spain.,Alcalá de Henares University, 28871, Alcalá de Henares, Spain
| | - Mercedes Guerra Requena
- Department of Vascular Surgery of Guadalajara University Hospital, 19002, Guadalajara, Spain
| | | | - José Valenzuela Torres
- Department of General Surgery of Guadalajara University Hospital, 19002, Guadalajara, Spain
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12
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Ogunsakin AA, Hilsenbeck HL, Portnoy DC, Nyenwe EA. Recurrent Severe Hypoinsulinemic Hypoglycemia Responsive to Temozolomide and Bevacizumab in a Patient With Doege-Potter Syndrome. Am J Med Sci 2018; 356:181-4. [PMID: 30219161 DOI: 10.1016/j.amjms.2018.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 01/16/2018] [Accepted: 01/19/2018] [Indexed: 11/20/2022]
Abstract
Nonislet cell tumor hypoglycemia is rare. We highlight the diagnosis and treatment of recurrent severe hypoglycemia in a 49-year-old woman with malignant solitary fibrous tumor of the pleura (Doege-Potter syndrome). The clinical, laboratory and radiologic findings of the case are presented and a brief literature review is provided. Of note, imaging studies showed a large mass in the right hemithorax and pathology and immunehistochemical stains confirmed a malignant solitary fibrous tumor of the pleura. She was a poor surgical candidate owing to a large tumor burden. She was treated with a combination of temozolomide and bevacizumab to which she responded with resolution of hypoglycemia. The treatment of choice for hypoglycemia in patients with the Doege-Potter syndrome is surgical excision. We here report that a combination of temozolomide and bevacizumab may be a viable option in patients with inoperable disease.
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13
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Avramenko A, Lahjibi-Paulet H, Gibault L, Roussel A, Grand B, Le Pimpec-Barthes F. Doege-Potter syndrome: hypoglycaemic coma in a 90-year old due to a solitary fibrous tumour. Age Ageing 2017; 46:527-529. [PMID: 27932370 DOI: 10.1093/ageing/afw221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Indexed: 11/14/2022] Open
Abstract
Solitary fibrous tumour of the pleura (SFTP) is a rare primary tumour of the pleura associated with 4% of cases with a paraneoplastic hypoglycaemia, termed Doege-Potter syndrome (DPS). We report a case of DPS presenting with severe coma in a 90-year-old woman. The cause was a malignant SFTP treated with surgical resection, from which the patient made a full recovery with prevention of recurrent hypoglycaemia. Surgical resection of the SFTP presenting with symptomatic hypoglycaemia should be considered even in elderly patients.
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Affiliation(s)
- Alla Avramenko
- Department of Thoracic Surgery and Lung Transplantation, Hopital Europeen Georges Pompidou, Paris, France
| | | | - Laure Gibault
- Department of Pathology, Hopital Europeen Georges Pompidou,Paris, France
| | - Arnaud Roussel
- Department of Thoracic Surgery and Lung Transplantation, Hopital Europeen Georges Pompidou, Paris, France
| | - Bertrand Grand
- Department of Thoracic Surgery and Lung Transplantation, Hopital Europeen Georges Pompidou, Paris, France
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14
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Le Coustumier EM, Vandeix E, Delage-Corre M, Bertin F, Melloni B. [Hypoglycaemic coma revealing a malignant recurrence during Doege-Potter syndrome]. Rev Mal Respir 2015; 32:530-4. [PMID: 26072009 DOI: 10.1016/j.rmr.2014.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 05/07/2014] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The Doege-Potter syndrome is a rare paraneoplastic syndrome, first described by Doege and Potter in 1930, that usually involves solid fibrous pleural tumours. Hypoglycaemia is a rare complication of these tumours, due to secretion of insulin-like growth factors, and it can be the presenting symptom. The incidence of malignancy is low, about 12-15 %. CASE REPORT An 81-year-old Caucasian man, operated on 20 years previously for a benign pleural fibroma, presented with several episodes of loss of consciousness due to profound hypoglycaemia and a history of increasing dyspnea. The chest X-ray revealed an intrathoracic mass. Following excision histological examination confirmed recurrence with malignant transformation to a high-grade sarcoma. CONCLUSION The Doege-Potter syndrome is a rare condition but it should be suspected in episodes of hypoglycaemia associated with a history of dyspnea. These patients should be followed up postoperatively because of the risk of tumour recurrence.
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Affiliation(s)
- E-M Le Coustumier
- Service de pathologie respiratoire et d'allergologie, hôpital du Cluzeau, CHU de Limoges, 23, avenue Dominique-Larrey, 87042 Limoges cedex, France.
| | - E Vandeix
- Service d'oncologie médicale, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - M Delage-Corre
- Service d'anatomopathologie et de cytologie, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - F Bertin
- Service de chirurgie thoracique et cardiovasculaire, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - B Melloni
- Service de pathologie respiratoire et d'allergologie, hôpital du Cluzeau, CHU de Limoges, 23, avenue Dominique-Larrey, 87042 Limoges cedex, France
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