Background
Doege-Potter syndrome is defined as paraneoplastic hypoinsulinemic
hypoglycemia associated with a benign or malignant solitary fibrous
tumor frequently located in pleural, but also extrapleural sites.
Hypoglycemia can be attributed to paraneoplastic secretion of
‘Big-IGF-II’, a precursor of Insulin-like growth factor-II. This
prohormone aberrantly binds to and activates insulin receptors, with
consecutive initiation of common insulin actions such as inhibition of
gluconeogenesis, activation of glycolysis and stimulation of cellular
glucose uptake culminating in recurrent tumor-induced hypoglycemic
episodes. Complete tumor resection or debulking surgery is considered
the most promising treatment for DPS.