Rosseel Liesbeth, De Leu Nico, Van Hecke Wim, Unuane David
Department of Internal Medicine, UZBrussel (VUB), Brussels, Belgium.
BMJ Case Rep. 2012 Jun 28;2012:bcr0320125972. doi: 10.1136/bcr.03.2012.5972.
A 57-year-old woman was admitted to the emergency department, presenting with episodes of altered consciousness and behaviour which, upon further examination, were linked to periods of recurrent hypoglycaemia. Imaging revealed a large mass in the right thoracic cavity while blood analysis demonstrated diminished C-peptide, (pro-)insulin, insulin-like growth factor 1 (IGF-I) and IGF binding protein 3 levels. Based on these findings, an IGF-II secreting tumour was suspected. Before the excision of the tumour, euglycaemia could only be achieved by means of intravenous glucose administration and the use of oral corticosteroids. Anatomopathologically the diagnosis of a solitary fibrous tumour (SFT) was confirmed. Immunoblot analysis on the serum revealed elevated 'big'-IGF-II levels, confirming our initial diagnosis of Doege-Potter syndrome in SFT.
一名57岁女性因意识和行为改变发作被紧急送往急诊科，进一步检查发现这些发作与反复低血糖发作期有关。影像学检查显示右胸腔有一个大肿块，血液分析显示C肽、（前）胰岛素、胰岛素样生长因子1（IGF-I）和IGF结合蛋白3水平降低。基于这些发现，怀疑是一种分泌IGF-II的肿瘤。在切除肿瘤之前，只有通过静脉注射葡萄糖和使用口服皮质类固醇才能实现血糖正常。解剖病理学确诊为孤立性纤维瘤（SFT）。血清免疫印迹分析显示“大”IGF-II水平升高，证实了我们最初对SFT中多伊格-波特综合征的诊断。
