Surgical resection of a solitary fibrous tumour causing refractory hypoglycaemia: Doege-Potter syndrome.

Abstract

Solitary fibrous tumours (SFTs) are rare soft tissue masses that are often clinically silent until they cause mass effect. A paraneoplastic syndrome manifesting as persistent hypoglycaemia, termed Doege-Potter syndrome (DPS), can be associated with these lesions. Surgical treatment is recommended for the management of these tumours.A case of a man in his 60s who was admitted for altered mental status and hypoglycaemia is herein described. Physical examination revealed a distended, asymmetric abdomen with a firm palpable mass in the left upper quadrant. Imaging demonstrated a 24 cm abdominal mass, confirmed to be an SFT on pathology. Biochemical evaluation was consistent with DPS. Surgical excision was performed; however, its large size and retroperitoneal location complicated intraoperative visualisation, ultimately requiring aortic reconstruction, multiple extremity fasciotomy, nephrectomy and prolonged intensive care unit stay.Few publications describe DPS. While tumour excision can be curative, this case report describes challenges that may arise with surgical management.