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Recurrent Hypoglycemia Due to a Massive Abdominal Tumor in a Nonagenarian: A Case Report and Review of the Literature

Patient: Male, 94-year-old Final Diagnosis: Doege Potter syndrome • solitary fibrous tumor Symptoms: Falls • hypoglycemia Medication: — Clinical Procedure: — Specialty: Geriatrics • Medicine, General and Internal OBJECTIVE: Unusual clinical course BACKGROUND: Whipple’s triad is a rare condition that...

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Autores principales: Reizun, Catherine E., Sorrells, W. Sheaffer, Grossman, Robert A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196397/
https://www.ncbi.nlm.nih.gov/pubmed/34088888
http://dx.doi.org/10.12659/AJCR.930727
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author Reizun, Catherine E.
Sorrells, W. Sheaffer
Grossman, Robert A.
author_facet Reizun, Catherine E.
Sorrells, W. Sheaffer
Grossman, Robert A.
author_sort Reizun, Catherine E.
collection PubMed
description Patient: Male, 94-year-old Final Diagnosis: Doege Potter syndrome • solitary fibrous tumor Symptoms: Falls • hypoglycemia Medication: — Clinical Procedure: — Specialty: Geriatrics • Medicine, General and Internal OBJECTIVE: Unusual clinical course BACKGROUND: Whipple’s triad is a rare condition that prompts urgent investigation. A rare cause of such a clinical presentation is excess production of insulin-like growth factor 2 (IGF-2) from a solitary fibrous tumor. CASE REPORT: A 94-year-old man presented to the hospital following episodes of confusion, gait disturbance, and multiple falls secondary to hypoglycemia. His initial blood glucose was 45 mg/dL, with normalization to 144 mg/dL after administration of 1 ampule of glucose in the field. By the time the patient arrived at our facility, his blood glucose had fallen to 75 mg/dL, and then fell further to 38 mg/dL. He had no preceding history of hypoglycemia and led an active lifestyle. His medical history was relatively unremarkable with the exception of a large but asymptomatic solitary fibrous tumor previously diagnosed, being managed conservatively. A physical examination demonstrated a large, left-sided, nontender abdominal tumor. Computed tomography demonstrated a very large well-defined, complex mass in the left upper quadrant of the abdomen. Hypoglycemic episodes occurred frequently, and reliably ensued with fasting. Hypoglycemia proved refractory to conservative strategies, and surgical intervention was recommended. Despite challenges due to the tumor’s characteristics, the mass was successfully resected and normoglycemia was achieved within 24 hours. CONCLUSIONS: Solitary fibrous tumors may rarely present with hypoglycemia refractory to medical therapy. We present the first reported case of a nonagenarian patient with hypoglycemia secondary to ectopic production of IGF-2 from a solitary fibrous tumor managed with surgical resection.
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spelling pubmed-81963972021-06-25 Recurrent Hypoglycemia Due to a Massive Abdominal Tumor in a Nonagenarian: A Case Report and Review of the Literature Reizun, Catherine E. Sorrells, W. Sheaffer Grossman, Robert A. Am J Case Rep Articles Patient: Male, 94-year-old Final Diagnosis: Doege Potter syndrome • solitary fibrous tumor Symptoms: Falls • hypoglycemia Medication: — Clinical Procedure: — Specialty: Geriatrics • Medicine, General and Internal OBJECTIVE: Unusual clinical course BACKGROUND: Whipple’s triad is a rare condition that prompts urgent investigation. A rare cause of such a clinical presentation is excess production of insulin-like growth factor 2 (IGF-2) from a solitary fibrous tumor. CASE REPORT: A 94-year-old man presented to the hospital following episodes of confusion, gait disturbance, and multiple falls secondary to hypoglycemia. His initial blood glucose was 45 mg/dL, with normalization to 144 mg/dL after administration of 1 ampule of glucose in the field. By the time the patient arrived at our facility, his blood glucose had fallen to 75 mg/dL, and then fell further to 38 mg/dL. He had no preceding history of hypoglycemia and led an active lifestyle. His medical history was relatively unremarkable with the exception of a large but asymptomatic solitary fibrous tumor previously diagnosed, being managed conservatively. A physical examination demonstrated a large, left-sided, nontender abdominal tumor. Computed tomography demonstrated a very large well-defined, complex mass in the left upper quadrant of the abdomen. Hypoglycemic episodes occurred frequently, and reliably ensued with fasting. Hypoglycemia proved refractory to conservative strategies, and surgical intervention was recommended. Despite challenges due to the tumor’s characteristics, the mass was successfully resected and normoglycemia was achieved within 24 hours. CONCLUSIONS: Solitary fibrous tumors may rarely present with hypoglycemia refractory to medical therapy. We present the first reported case of a nonagenarian patient with hypoglycemia secondary to ectopic production of IGF-2 from a solitary fibrous tumor managed with surgical resection. International Scientific Literature, Inc. 2021-06-05 /pmc/articles/PMC8196397/ /pubmed/34088888 http://dx.doi.org/10.12659/AJCR.930727 Text en © Am J Case Rep, 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Reizun, Catherine E.
Sorrells, W. Sheaffer
Grossman, Robert A.
Recurrent Hypoglycemia Due to a Massive Abdominal Tumor in a Nonagenarian: A Case Report and Review of the Literature
title Recurrent Hypoglycemia Due to a Massive Abdominal Tumor in a Nonagenarian: A Case Report and Review of the Literature
title_full Recurrent Hypoglycemia Due to a Massive Abdominal Tumor in a Nonagenarian: A Case Report and Review of the Literature
title_fullStr Recurrent Hypoglycemia Due to a Massive Abdominal Tumor in a Nonagenarian: A Case Report and Review of the Literature
title_full_unstemmed Recurrent Hypoglycemia Due to a Massive Abdominal Tumor in a Nonagenarian: A Case Report and Review of the Literature
title_short Recurrent Hypoglycemia Due to a Massive Abdominal Tumor in a Nonagenarian: A Case Report and Review of the Literature
title_sort recurrent hypoglycemia due to a massive abdominal tumor in a nonagenarian: a case report and review of the literature
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196397/
https://www.ncbi.nlm.nih.gov/pubmed/34088888
http://dx.doi.org/10.12659/AJCR.930727
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