Author of

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  P22 - Mesothelioma, Thymoma and Other Thoracic Malignancies - Case Reports (ID 136)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Mesothelioma, Thymoma and Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 35249

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    P22.06 - A Large Solitary Fibrous Tumor of the Pleura Causing Paraneoplastic Hypoglycemia (ID 3039)

    00:00 - 00:00  |  Presenting Author(s): Kohei Hashimoto
    • Abstract
    • Slides

    Introduction
    

    Refractory hypoglycemia (Doege-Potter syndrome) arises in <5 % of solitary fibrous tumors, particularly in large pleural/peritoneal tumors. This syndrome is known to be caused by tumor secretion of large insulin-like growth factor 2 (IGF-2) and surgical resection of the tumor is the treatment of choice.

    Methods
    

    A 78-year-old female presented to our emergency department with dizziness for a week. She did not have any previous history or any medications. Chest computed tomography revealed a 25-cm large tumor occupying the left hemithorax, shifting the mediastinum to the right (Arrows in Figure 1A). She was emergently admitted for concerning cardiovascular collapse. She developed syncope the next morning. Hypoglycemia (29 mg/dL), which was not apparent on admission, was revealed at that time. She responded to intravenous glucose immediately. In a systemic workup, no other lesions outside was documented. A pulmonary perfusion scan demonstrated only 1.8% in the left side. A percutaneous biopsy of the tumor revealed a solitary fibrous tumor. The hypoglycemia appeared to be a paraneoplastic syndrome (Doege-Potter syndrome). We resected the tumor through a clamshell incision (Arrows in Figure 1B). A left pneumonectomy was necessary (Figure 2).

    Results
    

    The hypoglycemia resolved immediately after removal of the tumor. The patient was discharged home on the 12th postoperative day. There were no complications. A pathological examination confirmed the diagnosis of solitary fibrous tumor with morphological features of malignancy. She was asymptomatic without recurrence 4 months after surgery.

    Conclusion
    

    The patient underwent a successful surgical treatment, which maintains recurrence-free survival in mid-term.

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