Doege-potter syndrome: a report of a histologically benign but clinically malignant case
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CASE REPORT
Open Access
Doege-potter syndrome: a report of a histologically benign but clinically malignant case Do Wan Kim, Kook Joo Na, Ju Sik Yun and Sang Yun Song*
Abstract Background: Solitary fibrous tumors of the pleura (SFTPs) are relatively rare tumors that originate from mesenchymal cells of submesothelial tissue of the pleura. Most patients with SFTPs are asymptomatic; however, pleuritic chest pain, cough, and dyspnea can develop. If hypoglycemia is associated with a solitary fibrous tumor, it is referred to as the Doege-Potter syndrome. Case presentation: A 70-year-old man had visited our hospital with a chief complaint of dyspnea, and he was diagnosed as having a solitary fibrous tumor. A few years later, he developed hypoglycemia, and he underwent excision of the mass. Conclusion: Occasionally, SFTPs induce several paraneoplastic events, such as hypertrophic osteoarthropathy. We described here a patient with an SFTP with Doege-Potter syndrome who was successfully treated with complete resection. Although lesions can be histologically benign, they can clinically present with malignant features. Keywords: Pleural disease, Tumor, Benign, Fibrous neoplasm
Background Solitary fibrous tumors of the pleura (SFTPs) are rare neoplasms that originate from the visceral pleura. If hypoglycemia is associated with a solitary fibrous tumor, it is referred to as the Doege-Potter syndrome [1]. Occasionally, histologically benign tumors can clinically present as malignant tumors [2, 3]. We describe an operative case of a patient with Doege-Potter syndrome that significantly interfered with his activities of daily living, although it was not malignant. Case presentation A 70-year-old man had visited our hospital with a chief complaint of dyspnea in 2004, and at that time, a 3.9 × 3.6-cm tumor in the right hemithorax was detected The tumor was diagnosed as a pulmonary solitary fibrous tumor by transthoracic needle biopsy (Fig. 1 a-c). However, the patient was lost to follow-up. In April 2011, he visited our hospital again with complaints of * Correspondence: [email protected] Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, 322 Seoyang-ro, Hwasun 519-763, Korea
acute shortness of breath. At that time, a large amount of pleural effusion and a 17 × 15-cm huge mass were observed on the chest radiograph, and a transthoracic needle biopsy and thoracentesis were performed accordingly. The tumor was diagnosed again as a solitary fibrous tumor, and surgical resection of the tumor was recommended. However, the patient refused to undergo the operation. When he visited our hospital to undergo positron emission tomography/computed tomography (CT), loss of consciousness developed suddenly while a blood sample was taken in the fasting state. Thus, he was admitted to the emergency room, and his blood glucose level was 38 mg/dL on admission. An examination of his medical history showed that the medication for diabetes mellitus was started 4
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