Solitary Fibrous Tumor With Doege-Potter Syndrome Successfully Treated With Preoperative Transcatheter Arterial Embolization and Complete Excision - A Case Report

Sep 29, 2026

Doege–Potter syndrome (DPS) is a rare paraneoplastic cause of severe hypoglycemia linked to solitary fibrous tumors (SFT). This case report details a 77-year-old patient with persistent hypoglycemia and a giant pelvic hypervascular SFT. Management included continuous TPN for severe episodes, preoperative transcatheter arterial embolization (TAE) of main feeders to reduce operative bleeding risk, and complete surgical excision via midline incision. Hypoglycemia resolved postoperatively and the patient remained recurrence-free for 11 months.

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CategoryHealthcare

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Abstract

Introduction

Case Presentation

Conclusion

Summary

CT Findings and Clinical Suspicion

Treatment Approach and Outcome

IJU Case Reports CASE REPORT OPEN ACCESS Solitary Fibrous Tumor With Doege–Potter Syndrome Successfully Treated With Preoperative Transcatheter Arterial Embolization and Complete Excision; A Case Report Rei Narimatsu1 | Ryuji Matsumoto1 | Haruka Miyata1 | Takahiro Osawa1 | Daisuke Abo2 | Kento Wakabayashi3 | Utano Tomaru3 | Hiraku Kameda4 | Izumi Fukuda5 | Takashige Abe1 1Department of Urology, Hokkaido University Hospital, Sapporo, Japan | 2Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan | 3Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan | 4Department of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan | 5Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan Correspondence: Takashige Abe ([takataka@rf6.so-net.ne.jp](takataka@rf6.so-net.ne.jp)) Received: 7 July 2025 | Revised: 13 September 2025 | Accepted: 30 September 2025 Keywords: Doege–Potter syndrome | solitary fibrous tumor | transcatheter arterial embolization ABSTRACT Introduction: Doege–Potter syndrome (DPS) is a rare paraneoplastic phenomenon of severe hypoglycemia associated with solitary fibrous tumors (SFT). We report a case of a giant pelvic SFT with DPS, which was managed with preoperative arterial embolization and complete excision. Case Presentation: This report describes the case of a 77-year-old patient with persistent hypoglycemia and a giant pelvic mass. He required continuous total parenteral nutrition (TPN) for severe hypoglycemia. CT showed a giant hypervascular mass (20 × 18 × 15cm) in the pelvic space. Tumor biopsy showed SFT. To avoid intraoperative brisk bleeding, transcatheter arterial embolization (TAE) of the main feeders was performed 1 day before surgery. The tumor was completely resected via midline abdominal incision. Hypoglycemia resolved postoperatively. He was recurrence-free for 11 months after surgery. Conclusion: The combination of preoperative TAE and surgical resection appears to be an effective therapeutic strategy for DPS-associated SFT. 1 | Introduction and Background Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm of fibroblastic origin. In fewer than 5% of cases, it is associated with refractory hypoglycemia, known as Doege–Potter syndrome (DPS) [1, 2] . This paraneoplastic hypoglycemia results from tumor-derived secretion of high-molecular-weight insulinlike growth factor 2 (IGF-II) [3] . Since its first report in 1930, the management of DPS has remained non-systematic due to its rarity [4, 5]. Herein, we present a case of pelvic SFT with DPS successfully managed with preoperative transcatheter arterial embolization (TAE) and complete excision. 2 | Case Presentation A 77-year-old man was emergently transported due to loss of consciousness. Examination revealed hypoglycemia and an intrapelvic mass. He required continuous total parenteral nutrition (TPN) due to severe hypoglycemia. His medical history This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2026 The Author(s). IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Urological Association. IJU Case Reports, 2026; 9:e70107 1 of 6 [https://doi.org/10.1002/iju5.70107](https://doi.org/10.1002/iju5.70107) Summary • We report a case of a giant pelvic solitary fibrous tumor (SFT) presenting with severe hypoglycemia, along with Doege–Potter syndrome. • To avoid the risk of intraoperative brisk bleeding, preoperative transcatheter arterial embolization (TAE) was performed to occlude the primary feeding vessels. • This approach enabled the safer surgical excision of the tumor without an extensive amount o

FAQs

What condition links solitary fibrous tumors to severe hypoglycemia in this case?

The report describes Doege–Potter syndrome (DPS), a rare paraneoplastic phenomenon causing severe hypoglycemia associated with solitary fibrous tumors.

Why was preoperative transcatheter arterial embolization (TAE) performed?

TAE was used to occlude the main feeding vessels to avoid intraoperative brisk bleeding and enable safer complete excision of the large pelvic tumor.

What was the outcome after surgery and embolization?

Postoperatively, hypoglycemia resolved, and the patient remained recurrence-free for 11 months after complete tumor resection.

Sep 29, 2026

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