Solitary Fibrous Tumor Generated From Uterine Corpus With Doege-Potter Syndrome in Primary Disease: A Rare Case of Recurrent Disease Without Hypoglycemia.

INTRODUCTION: Solitary fibrous tumors (SFTs) generated from uterine corpus are extremely rare and hard to distinguish from myomas, but their prognoses are wildly different. Doege-Potter syndrome (DPS) is a form of nonislet cell tumor hypoglycemia (NITCH) caused by a SFT. Vigilance is required when a pelvic mass is found concurrent with NITCH.

CASE PRESENTATION: A 65-year-old female with huge pelvic masses generated from uterine corpus presented with mild symptoms of transient slow response, accompanied by memory loss once, and was found to have hypoglycemia. The pituitary glucocorticoid axis, pituitary sex hormone axis, and pituitary growth hormone axis functioned normally; insulin release was normal, but relatively low insulin levels indicated suppression of secretion. Abdominal total hysterectomy and bilateral salpingo-oophorectomy were performed, and pathology confirmed a benign SFT with DPS. Blood glucose levels after surgery are significantly elevated and more stable. This case fell into the intermediate-risk group, but the disease recurred. Cytoreduction surgery was performed 13 months after initial treatment without DPS.

DISCUSSION: Uterine corpus-generated SFTs are hard to distinguish preoperatively. However, complete tumor resection is a key prognostic factor because SFTs have a risk of long-term recurrence. DPS can be a differential diagnostic point, but there is no significant relation between tumor burden and recurrence.