From Hypoglycaemia to Haemorrhage: A Case of Giant Pleural Solitary Fibrous Tumour With Doege–Potter Syndrome

Doege-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 × 169 mm) 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.