Doege-
Potter syndrome with acromegaloid facial changes is extremely rare. Uncooked
cornstarch along with
glucocorticoids have been used as supportive care in patients with non-
islet cell tumor hypoglycemia (NICTH). Preoperative embolization of hepatic
solitary fibrous tumors (SFT) with NICTH has yielded unsatisfactory results. Herein we present the case of a 61-year-old man with a 3-month history of severe frequent
hypoglycemic episodes and acromegaloid facial changes. During a spontaneous
hypoglycemia (26 mg/dL), laboratory values showed a hypoinsulinemic pattern with low levels of GH, IGFPB3, and an IGF2/IGF1 ratio of 8.5:1. Cross-sectional imaging revealed a large (16 × 13 × 11 cm) hepatic
tumor, and cytology was consistent with SFT. A preoperative right portal embolization was performed in an effort to induce normal remnant liver
hypertrophy to allow for safe
tumor resection. After the procedure, uncooked
starch treatment followed by
prednisone was started, achieving complete remission of
hypoglycemic episodes in the preoperative setting. He subsequently underwent partial
hepatectomy. The histologic diagnosis was compatible with a potentially malignant SFT. The patient had an excellent outcome with complete remission of
hypoglycemia, improvement of facial acromegaloid changes, and no further evidence of disease. To our knowledge, this is the first case of a patient with Doege-
Potter syndrome with acromegaloid facial changes induced by a potentially malignant liver SFT, treated successfully with a multimodal approach consisting of uncooked
cornstarch, low-dose
prednisone, preoperative embolization, and complete surgical resection. The use of
cornstarch and low-dose
glucocorticoids may be an adequate treatment in advance of undergoing surgery.