Table 2 Management strategies for Doege-Potter syndrome
Strategy | Advantages | Disadvantages |
|---|---|---|
Surgically remove underlying tumor | Most solitary fibrous tumors are benign and adequate resection resolves hypoglycemia | Invasive; may not be a viable option (for example, malignant tumors with metastasis) |
Systemic or localized chemotherapy | May be used to treat non-resectable tumors | Chemotherapy regimens are not well studied; significant side effects associated with chemotherapy; tumors are typically poorly responsive to systemic chemotherapy |
Scheduled snacks | Non-invasive | Relies on patient adherence to schedule |
Nocturnal or continuous dextrose infusion | Reliably prevents hypoglycemia | Requires long-term venous access with attendant risks (for example, infection) |
Nocturnal or continuous enteral tube feeding | Reliably prevents hypoglycemia | Long-term use requires invasive placement of gastrostomy tube |
Corticosteroid administration | Non-invasive; may normalize insulin-like growth factor levels; increases appetite | Multiple adverse effects of long-term corticosteroid use |
Continuous glucagon infusion [6] | Effective to prevent hypoglycemia in some patients; subcutaneous administration has less infectious risk than direct venous access | May be practically difficult |