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Successful multidisciplinary treatment of Doege-Potter syndrome: hypoglycaemia caused by paraneoplastic IGF-2 production by a metastatic haemangiopericytoma
  1. Jeffery Tong1,
  2. Jonathan Athayde1,
  3. Shawn MacKenzie2 and
  4. Meghan Ho3
  1. 1Department of Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
  2. 2Department of Surgery, The University of British Columbia Faculty of Medicine, New Westminster, British Columbia, Canada
  3. 3Department of Medicine, The University of British Columbia Faculty of Medicine, New Westminster, British Columbia, Canada
  1. Correspondence to Dr Jeffery Tong; JefferyTong{at}alumni.ubc.ca

Abstract

Hypoglycaemia due to insulin-like growth factor (IGF)-2 secretion is a paraneoplastic complication of malignancy with significant morbidity that can often go unrecognised due to its uncommon presentation. We report on a case of a 51-year-old man with metastatic haemangiopericytoma presenting with refractory hypoglycaemia, requiring continuous dextrose 10% infusion while in hospital. IGF-2 levels were significantly elevated, in keeping with a rare entity associated with solitary fibrous tumours, known as Doege-Potter syndrome. The patient was managed using uncooked cornstarch in conjunction with debulking of the hepatic tumour burden with bland IR-guided transarterial embolisation, and eventual surgical resection to treat his non-islet cell tumour hypoglycaemia (NICTH). The case highlights this rare paraneoplastic phenomenon that should be included in the differential for hypoglycaemia, especially if a history of a solitary fibrous tumour is elicited. Our case is the first to document a successful approach to treating the hypoglycaemia using preoperative transarterial bland embolisation.

  • interventional radiology
  • oncology
  • endocrinology
  • cancer intervention
  • surgical oncology

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Footnotes

  • Contributors Patient was under the care of MH and SM. Report was written and edited by all authors. Dr Arun Garg (Medical Biochemistry) was also instrumental in helping our team arrange for IGF-2 testing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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