Lung Image: Doege–Potter Syndrome

Excerpt

A 37-year-old male patient presented to an external clinic reporting dyspnea, fatigue, dizziness, and intermittent episodes of syncope. Upon blood testing, he was found to have hypoglycemia. His anamnesis revealed a surgical procedure and radiotherapy was performed 6 years prior due to a solitary fibrous tumor in his right hemithorax. He had no history of diabetes or medication at all. The patient was somnolent and his blood pressure was 125/80 mmHg, pulse was 95 bpm, and breathing rate was 19 breaths/min. Upon auscultation, no respiratory sounds were heard in the right hemithorax. His blood glucose level was approximately 50 mg/dL and his serum insulin level was 3.4 μU/mL. An intravenous infusion of 50% glucose was performed in an attempt to keep the patient’s blood glucose level within normal limits. Upon chest X-ray, opacity was observed in his right hemithorax. During thoracic tomography, a giant heterogeneous mass was seen in his right hemithorax (Fig. 1). No FDG uptake was observed in PET–CT scans (Fig. 2). The patient was reported to have a solitary fibrous tumor following a transthoracic fine-needle aspiration biopsy. A total excision of the mass and pleura with right redo posterolateral thoracotomy was performed next (Fig. 3). The patient’s blood glucose level remained within normal limits in the postoperative period. He was discharged on postoperative day 8. Macroscopic examination of the specimen revealed that it had well-circumscribed, smooth-surfaced, and capsulated large lobular masses. Following a histopathological examination, the patient was diagnosed with a malignant solitary fibrous tumor of the pleura with pleomorphism and high cellularity (Fig. 4). After a year of follow-up visits, the patient was still asymptomatic. …