Milenković Branislava, Stojsić Jelena, Dudvarski Aleksandra, Bosnjak-Petrović Vesna, Ercegovac Maja
Srp Arh Celok Lek. 2007 May-Jun;135(5-6):326-9. doi: 10.2298/sarh0706326m.
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.
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.
Clinicians should be aware of this rare, but important cause of hypoglycaemia and exclude a fibrous pleural tumour in the assessment of their patients.
胸膜孤立性纤维瘤并不常见，多偶然发现或出现在有非特异性呼吸道症状的患者中。当与低血糖相关时，通常被称为多伊格-波特综合征。
一名68岁女性出现一个巨大的胸膜肿块。她有长期头痛和意识减退病史，伴有一年来逐渐加重的呼吸困难和右侧胸痛。胸部X线显示一个巨大的不透光区，几乎占据了整个右半胸。内分泌检查显示血糖水平极低，胰岛素、C肽、胰高血糖素、生长激素和儿茶酚胺的血浓度在正常范围内。细针穿刺后，经组织学和免疫组化分析，诊断为良性孤立性纤维性胸膜肿瘤。虽然手术切除如此巨大且伴有低血糖的肿瘤通常可治愈，但我们的患者拒绝手术，选择了静脉输注葡萄糖的保守治疗。
临床医生应意识到这种罕见但重要的低血糖病因，并在评估患者时排除纤维性胸膜肿瘤。
