{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:35:55Z","timestamp":1791304555986,"version":"4.3.1"},"reference-count":8,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"vor","delay-in-days":46,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Doege-Potter syndrome occurs when incompletely processed insulin-like growth factor 2 (IGF-2), also known as big IGF-2, is produced by a solitary fibrous tumor (SFT) and results in non-islet cell tumor hypoglycemia (NICTH). We discuss here the case of a 66-year-old male who presented with a 2-week history of increasing confusion and a serum glucose of 34\u2005mg\/dL. The patient's symptoms immediately improved with dextrose. The patient did not use insulin, serum sulfonylurea screen was negative, and testing for adrenal insufficiency was unremarkable. Outpatient laboratory evaluation revealed a serum glucose of 48\u2005mg\/dL along with low insulin, C-peptide, and proinsulin levels. Further work-up showed an IGF-2 to IGF-1 ratio of 38:1. A ratio greater than 10:1 is diagnostic of NICTH. Imaging demonstrated a 21-cm mass in the lower abdomen and pelvis. The patient underwent surgical resection. The hypoglycemia resolved immediately postoperatively. Surgical pathology revealed a malignant SFT. In NICTH, big IGF-2 forms a complex that is biologically active and saturates the insulin and IGF receptors, resulting in refractory hypoglycemia. Although glucocorticoids can mitigate hypoglycemia, complete surgical resection is the only definitive treatment of NICTH. This case highlights the importance of maintaining a broad differential for seemingly simple hypoglycemia.<\/jats:p>","DOI":"10.1210\/jcemcr\/luae017","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T15:52:32Z","timestamp":1708703552000},"source":"Crossref","is-referenced-by-count":4,"title":["Doege-Potter Syndrome: A Solitary Fibrous Tumor Causing Non-Islet Cell Tumor Hypoglycemia"],"prefix":"10.1210","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1477-6358","authenticated-orcid":false,"given":"Khalid","family":"Sheikh","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Dell Medical School at the University of Texas at Austin , Austin, TX 78712 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7167-4382","authenticated-orcid":false,"given":"Avni","family":"Mody","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology, Dell Medical School at the University of Texas at Austin , Austin, TX 78712 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5731-329X","authenticated-orcid":false,"given":"Alex B","family":"Haynes","sequence":"additional","affiliation":[{"name":"Department of Surgery and Perioperative Care and Department of Oncology, Dell Medical School at the University of Texas at Austin , Austin, TX 78712 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4347-0286","authenticated-orcid":false,"given":"Pratima","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology, Dell Medical School at the University of Texas at Austin , Austin, TX 78712 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"2024022817594734100_luae017-B1","first-page":"17","article-title":"Hypoinsulinemic hypoglycemia triggered by liver injury in elderly subjects with low body weight: case reports","volume":"2018","author":"Anno","year":"2018","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"issue":"4","key":"2024022817594734100_luae017-B2","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1080\/17843286.2023.2165652","article-title":"Doege-Potter syndrome in a patient with a giant abdominal solitary fibrous tumor: a case report and review of the literature","volume":"78","author":"R\u00f6tgens","year":"2023","journal-title":"Acta Clin Belg"},{"issue":"7-8","key":"2024022817594734100_luae017-B3","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.cancergen.2016.05.071","article-title":"The NAB2\u2013STAT6 gene fusion in solitary fibrous tumor can be reliably detected by anchored multiplexed PCR for targeted next-generation sequencing","volume":"209","author":"Guseva","year":"2016","journal-title":"Cancer Genet"},{"issue":"1","key":"2024022817594734100_luae017-B4","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1186\/s12902-022-01175-4","article-title":"IGF-2 mediated hypoglycemia and the paradox of an apparently benign lesion: a case report & review of the literature","volume":"22","author":"Crowley","year":"2022","journal-title":"BMC Endocr Disord"},{"issue":"6","key":"2024022817594734100_luae017-B5","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1210\/er.2012-1033","article-title":"Tumors, IGF-2, and hypoglycemia: insights from the clinic, the laboratory, and the historical archive","volume":"34","author":"Dynkevich","year":"2013","journal-title":"Endocr 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