A case of retroperitoneal Doege-Potter syndrome with continuous intraoperative blood glucose monitoring

Abstract

Abstract Background: Doege-Potter syndrome presents as solitary fibrous tumors and non-islet cell tumor hypoglycemia (NICTH). Here, we report a case of Doege-Potter syndrome in which retroperitoneal tumor resection was performed with continuous intraoperative blood glucose monitoring. Case Presentation: The patient was a 37-year-old healthy man with no relevant medical history. They were brought to the emergency room because of defecation difficulties and incontinence caused by hypoglycemia, and a tumor measuring 10 × 12 × 9 cm was found in the right kidney. High-molecular-weight insulin-like growth factor-II (IGF-II) was detected in the blood, indicating an IGF-II-producing tumor with NICTH. The patient underwent tumor resection, and the pathological results indicated a solitary fibrous tumor of retroperitoneal origin. Thus, retroperitoneal primary Doege-Potter syndrome was diagnosed. Continuous blood glucose monitoring was performed intraoperatively, and no hypoglycemic attacks occurred; insulin secretory abnormalities improved immediately after surgery. Previous studies suggest that IGF-II is metabolized in a few hours. Therefore, serum IGF-II levels were analyzed one week and one month postoperatively; the levels were within the normal range at both time points. Two years have passed since the surgery without recurrence. Conclusions: Doege-Potter syndrome of retroperitoneal primary origin is rare. Furthermore, continuous intraoperative blood glucose monitoring was performed during surgery; thus, we report blood glucose level trends for the first time. This case highlights that this type of surgery can be performed safely without special blood glucose adjustments and that insulin secretion resumes soon after surgery.