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.