Keywords
hypoglycemia
pleural neoplasms
insulin-like growth factors
Paraneoplastic syndromes
Lung
How to Cite
Abstract
Introduction: Doege-Potter syndrome is a rare cause of non–insulin-mediated hypoglycemia, secondary to solitary fibrous tumors that produce insulin-like growth factor 2 (IGF-2). Its low frequency and the nonspecific nature of its clinical manifestations make timely diagnosis challenging; therefore, it should be considered in the differential diagnosis of persistent hypoglycemia in non-diabetic patients. We present the case of a patient with this syndrome treated at a university hospital in Bogotá, Colombia.
Case presentation: A 71-year-old woman with a history of seropositive rheumatoid arthritis, irregularly treated with prednisolone, and prior pulmonary mass resection in 2011 without histopathological report, presented with a 4-hour history of asthenia, somnolence, and disorientation. Severe hypoglycemia was documented (46 mg/dL by glucometer and 26 mg/dL in plasma glucose), persistent despite dextrose administration. She denied the use of hypoglycemic agents; glycated hemoglobin was 4.7%. Hormonal profile showed low insulin, C-peptide, and proinsulin levels, consistent with non–insulin-mediated hypoglycemia. Chest computed tomography revealed a left subpulmonic mass measuring 153 × 98 mm, and biopsy confirmed a solitary fibrous tumor (positive for STAT6, CD34, vimentin, and BCL2; Ki-67 index of 4%). Based on these findings, a diagnosis of Doege-Potter syndrome was established.
Discussion: Doege-Potter syndrome represents a diagnostic challenge due to its low frequency and nonspecific clinical presentation. Suspicion should arise in cases of non insulin-mediated hypoglycemia, particularly when a paraneoplastic origin is considered. Correlation with clinical and imaging findings is essential to guide timely diagnosis.
Conclusion: Early recognition of Doege-Potter syndrome and timely surgical resection of the solitary fibrous tumor are crucial to improve prognosis and prevent potentially severe metabolic complications.
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