Benign solitary fibrous pleural tumour and hypoglycaemia

Abstract

INTRODUCTION: Solitary fibrous tumours 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 tumour was diagnosed. Although surgical resection of such a huge tumour 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 tumour in the assessment of their patients.