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一名表现为副肿瘤性低胰岛素血症性低血糖(多伊格-波特综合征)的患者出现胸段孤立性纤维瘤第三次复发

The Third-Time Recurrence of a Thoracic Solitary Fibrous Tumor in a Patient Presenting With Paraneoplastic Hypoinsulinemic Hypoglycemia (Doege-Potter Syndrome).

作者信息

Zakar Rida, Saad Nader, Nehme Karim, El Sett Antoine, El Sett Pierre, Tabet Georges

机构信息

Medicine, Université Saint Joseph, Beirut, LBN.

Thoracic and Vascular Surgery, Hôtel-Dieu de France, Beirut, LBN.

出版信息

Cureus. 2024 May 14;16(5):e60256. doi: 10.7759/cureus.60256. eCollection 2024 May.

Abstract

We present a case of a 76-year-old Caucasian female with a recurrent solitary fibrous tumor (SFT) of the pleura, showcasing a rare manifestation of hypoglycemia associated with Doege-Potter syndrome (DPS). Having undergone two previous surgeries for SFT, the patient presented to the emergency department with severe fatigue, recurrent episodes of loss of consciousness, and hypoglycemia, despite lacking a history of diabetes mellitus. Radiological evaluation revealed a substantial recurrent SFT in the left lung, prompting excision through a left posterolateral thoracotomy. Remarkably, the patient's altered mental status and hypoglycemia resolved postoperatively. The case meets the criteria for aggressive SFT behavior, warranting consideration for adjuvant radiation therapy to control the risk of recurrence. This report highlights the nuanced interplay between SFT recurrence, paraneoplastic syndromes like DPS, and the potential benefits of adjuvant therapeutic strategies in managing these complex clinical scenarios.

摘要

我们报告了一例76岁的白种女性,患有复发性胸膜孤立性纤维瘤(SFT),表现出与多伊奇-波特综合征(DPS)相关的低血糖罕见表现。该患者此前因SFT接受过两次手术,此次因严重疲劳、反复意识丧失发作和低血糖就诊于急诊科,尽管无糖尿病病史。影像学评估显示左肺有大量复发性SFT,遂通过左后外侧开胸手术进行切除。值得注意的是,患者术后精神状态改变和低血糖症状得到缓解。该病例符合侵袭性SFT行为的标准,有必要考虑辅助放疗以控制复发风险。本报告强调了SFT复发、DPS等副肿瘤综合征以及辅助治疗策略在处理这些复杂临床情况中的潜在益处之间的细微相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05ef/11092924/f03459118f49/cureus-0016-00000060256-i01.jpg

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Solitary fibrous tumor.孤立性纤维性肿瘤
Transl Gastroenterol Hepatol. 2018 Nov 21;3:94. doi: 10.21037/tgh.2018.11.02. eCollection 2018.
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Doege-Potter Syndrome.多伊格-波特综合征
Ann R Coll Surg Engl. 2015 Oct;97(7):e105-7. doi: 10.1308/rcsann.2015.0023.

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