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A 76-year-old man presented with recurrent severe hypoglycaemia and significant weight loss. Imaging confirmed a giant right pleurally-based SFT, and management used intravenous dextrose and glucagon until surgical resection. Post-operative glucose normalized, while histopathology showed a spindle cell SFT without malignant features.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/from-hypoglycaemia-to-haemorrhage-a-case-of-giant-pleural-solitary-fibrous-tumour-with-doegepotter-syndrome/433353/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/from-hypoglycaemia-to-haemorrhage-a-case-of-giant-pleural-solitary-fibrous-tumour-with-doegepotter-syndrome/433353.png","ImageObject",300,407,{"name":92,"@type":93},"hdkawk","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What causes Doege–Potter syndrome in solitary fibrous tumours?","Question",{"text":112,"@type":113},"It is caused by ectopic secretion of an unprocessed high molecular weight form of insulin-like growth factor II (big-IGF-II) by the tumour, leading to hypoglycaemia.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the patient’s hypoglycaemia managed before surgery?",{"text":117,"@type":113},"Hypoglycaemia was treated with intravenous dextrose infusion and glucagon, with blood glucose maintained using dextrose infusions and injections.",{"name":119,"@type":110,"acceptedAnswer":120},"What key imaging and pathology findings supported the final diagnosis?",{"text":121,"@type":113},"Magnetic resonance imaging confirmed a giant right pleurally-based SFT, and histopathology showed a spindle cell SFT without malignant features.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},433353,1790741761,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},3985747859855,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Respirology Case Reports  \nCASE REPORT  OPEN ACCESS   \nFrom Hypoglycaemia to Haemorrhage: A Case of Giant Pleural Solitary Fibrous Tumour With Doege–Potter Syndrome  \nMichael Xie1  | Ronan O'Donnabhain2 | Zemin Cao2 | Jazmin Eckhaus2 | Phillip Parente2,3 | Alan Wong4 | David Holcdorf2 | Victor Duong1,2   \n1Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia | 2Epworth HealthCare, Melbourne, Victoria, Australia | 3Eastern Health Clinical School, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia | 4Melbourne Pathology, Melbourne, Victoria, Australia  \nCorrespondence: Victor Duong ([victor.duong@live.com.au](victor.duong@live.com.au))  \nReceived: 14 September 2025 | Revised: 5 November 2025 | Accepted: 16 November 2025  \nAssociate Editor: Sita Andarini  \nKeywords: Doege–Potter syndrome (DPS) | non-diabetic hypoglycaemia | solitary fibrous tumours (SFT)  \nABSTRACT  \nDoege–Potter Syndrome (DPS) is a rare paraneoplastic cause of hypoglycaemia, arising from solitary fibrous tumours (SFTs) that ectopically secrete insulin-like growth factor II (IGF-II) . We report a case of DPS in a 76-year-old man presenting with recurrent severe hypoglycaemia. Biochemistry investigations revealed hypoglycaemia with suppressed insulin, C-peptide and beta-hydroxybutyrate levels. Magnetic resonance imaging (MRI) confirmed a giant (205 × 190 × 169mm) right pleurally-based SFT. Hypoglycaemia was managed with intravenous dextrose infusion and glucagon until surgical resection via thoracotomy. A massive transfusion protocol was activated for intra-operative bleeding. Histopathology confirmed a spindle cell SFT without malignant features. Post-operative blood glucose levels normalised, and the patient was discharged without complication. This case highlights the diagnostic challenges of DPS, the potential to maintain pre-operative normoglycaemia without glucocorticoid therapy and the importance of recognising tumour vascularity to guide pre-operative planning and reduce bleeding risk.  \n1 | Introduction  \nSolitary fibrous tumours (SFTs) are rare mesenchymal tumours with an incidence of 1 per 1,000,000 persons per year [1] . The median age is 50–60, with the majority of cases arising from serosal membranes—predominantly the dura of the meninges (40% of all cases) . Extra-meningeal sites include the abdominal cavity (31% of extra-meningeal sites), limbs (29%) and pleura (22%) [2] . Giant SFT is generally accepted as SFT over 15 cm in diameter or occupying at least 40% of the hemithorax [3] . Most SFTs are highly vascularised, well-defined masses with variable potential for metastasis. Two paraneoplastic syndromes associated with SFTs include hypertrophic osteoarthropathy,  \ninvolved in less than 10% of cases and hypoglycaemia in less than 5% of cases [4] .  \nParaneoplastic hypoglycaemia in SFTs, otherwise known as Doege–Potter syndrome (DPS), was named after Karl Doege and Roy Potter in 1930 after they described the first case of fibrous tumour-associated hypoglycaemia. DPS occurs due to the excessive ectopic secretion of an unprocessed high molecular weight form of insulin-like growth factor II (IGF-II), known as big-IGF-II [4] . It remains a rare condition with approximately 76 reported cases in the literature. Diagnosis is a combination of characteristic biochemistry (reduced insulin/C-peptide/proinsulin/beta-hydroxybutyrate), imaging and adequate exclusion  \nThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.  \n© 2026 The Author(s). Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.  \nRespirology Case Reports, 2026; 14:e70423 1 of 4  \n[https://doi.org/10.1002/rcr2.70423](https://doi.or","cbCaisehcrSZIOmV","https://ap.wps.com/l/cbCaisehcrSZIOmV","pdf",1306450,"English","# Introduction\n# Case Report","[{\"question\":\"What causes Doege–Potter syndrome in solitary fibrous tumours?\",\"answer\":\"It is caused by ectopic secretion of an unprocessed high molecular weight form of insulin-like growth factor II (big-IGF-II) by the tumour, leading to hypoglycaemia.\"},{\"question\":\"How was the patient’s hypoglycaemia managed before surgery?\",\"answer\":\"Hypoglycaemia was treated with intravenous dextrose infusion and glucagon, with blood glucose maintained using dextrose infusions and injections.\"},{\"question\":\"What key imaging and pathology findings supported the final diagnosis?\",\"answer\":\"Magnetic resonance imaging confirmed a giant right pleurally-based SFT, and histopathology showed a spindle cell SFT without malignant features.\"}]","From Hypoglycaemia to Haemorrhage - A Case of Giant Pleural Solitary Fibrous Tumour With Doege–Potter Syndrome | PDF",1790663722]