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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 69-year-old woman underwent laboratory tests for asthenia&#44; which measured a blood glucose level of 17&#46; The patient complained of moderate effort dyspnea and dry cough&#46; Chest radiography revealed submassive left pleural effusion&#44; for which thoracentesis was performed&#44; obtaining a hematological exudate with a glucose level higher than in serum&#46; Computed tomography showed a considerable solid and heterogeneous mass measuring 14&#46;6<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>15&#46;4<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>cm&#44; with calcification&#46; There were also areas with increased uptake&#44; necrotic areas and cystic degeneration areas&#44; which affected the parietal pleura in its middle and lower parts&#44; without infiltrating the chest wall&#46; This mass caused considerable mediastinal and cardiac displacement and presented significant vascularization with numerous vascular branches dependent on both the descending and abdominal aortas &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figs&#46; 1A&#8211;C</a>&#41;&#46; We ruled out hyperinsulinism&#44; and the insulin-like growth factor-I and II measurements were normal&#46; From the morphological and immunohistochemical standpoint&#44; the biopsy was compatible with a solitary fibrous pleural tumor&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Solitary fibrous tumors represent 8&#37; of benign chest malignancies and 10&#37; of pleural tumors&#46; The tumors originate in serous membranes&#44; dura mater and deep soft tissues&#46; Thirty percent of these tumors occur in the chest cavity and usually have a benign course and a casual diagnosis&#46; The tumors can cause coughing&#44; dyspnea&#44; chest pain&#44; pleural effusion&#44; joint pain&#44; acropachy and hypoglycemia&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Refractory hypoglycemia &#40;Doege-Potter syndrome&#41; occurs in less than 5&#37; of cases&#44; mainly in peritoneal&#47;giant pleural tumors&#46; The condition is characteristically hypoinsulinemic and caused by the tumor secretion of a &#8220;big&#8221; growth factor similar to type 2 insulin &#40;big-IGF2&#41;&#44; which acts by displacing the IGF of transport proteins&#46; Tumor extirpation typically eliminates the symptoms&#46;</p></span>"
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Medicine in images
DOI: 10.1016/j.rceng.2018.10.004
Doege-Potter syndrome: What hypoglycemia hid
Síndrome de Doege-Potter: lo que la hipoglucemia escondía
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S.M. Santos-Seoanea,
Corresponding author
smsspulp@yahoo.es

Corresponding author.
, R. Fernández-Madera-Martíneza, H. Canto-Argizb
a Servicio de Medicina Interna, Hospital de Cabueñes, Gijón, Asturias, Spain
b Servicio de Neumología, Hospital de Cabueñes, Gijón, Asturias, Spain

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