Benign solitary fibrous pleural tumor and hypoglycaemia

Abstract

Introduction: Solitary fibrous tumors of the pleura are uncommon and discovered fortuitously or in patients with non-specific respiratory symptoms. When associated with hypoglycaemia, they are commonly referred to as Doege-Potter syndrome. Case outline. A 68-year old woman presented with a large pleural mass. She had a long history of headache and decreased consciousness with one-year worsening dyspnoea and right-sided chest pain. The chest X-ray revealed an enormous opacity occupying almost the entire right hemithorax. Endocrine tests showed an extremely reduced glucose level and blood concentration of insulin, C-peptide, glucagon, growth hormone and catecholamines within normal range. After fine-needle aspiration, by histological and immunohistochemical analysis, a benign solitary fibrous pleural tumor was diagnosed. Although surgical resection of such a huge tumor with hypoglycaemia is usually curative, our patient declined surgery and opted for conservative treatment with intravenous glucose. Conclusion. Clinicians should be aware of this rare, but important cause of hypoglycaemia and exclude a fibrous pleural tumor in the assessment of their patients. .