Pleuropulmonary solitary fibrous tumour with paraneoplastic syndrome

The pleuropulmonary solitary fibrous tumour (SFT) is a rare type of tumour. This paper outlined a 63-year-old female who came to the hospital with two weeks history of chronic cough, shortness of breath, and hypoglycemia. Contrast-Enhanced CT Thorax showed a huge heterogeneously-enhancing mass occupying the right hemithorax. US-guided biopsy followed by histological examination showed the features of an SFT. In view of the association between pleuropulmonary SFT and hypoglycaemia, the patient was highly likely to be suffering from a paraneoplastic syndrome known as Doege-Potter Syndrome

Pleuropulmonary solitary fibrous tumour (SFT)

Introduction Solitary fibrous tumors (SFTs) are relatively rare neoplasms that commonly occur in the pleura. The tumor infrequently has been associated with paraneoplastic syndromes, most commonly reported is non-islet cell tumor hypoglycaemia (Doege Potter Syndrome). Case Report Case Report – A 63 year old female, non smoker, non diabetic presented to district hospital with history of cough for 2 weeks, difficulty breathing and constitutional symptoms. CXR noted homogenous opacity obscuring right hemothorax, mediastinal shifted with tracheal deviated to the left. CECT Thorax showed huge heterogeneously enhancing mass occupying the right hemithorax. It measures approximately 16.4 cm x 16.5 cm x 21.1 cm. Minimal residual collapsed lung noted at right apical region. Pleural tapping done at district hospital noted exudative picture. Patient also noted to have unexplained hypoglycaemia initially thought to be adrenal metastasis and was started on IV Hydrocortisone 100mg TDS however the hypoglycemia persist. Upon transferred to our care, patient was on NIV and noted patient had superior vena cava syndrome (SVCS) and she was started on IV Dexametasone high dose. SVCS and refractory hypoglycemia improved remarkably with dexamethasone. Trucut biopsy of right lung mass done under ultrasound guided. Result Microscopically, the biopsy show spindle to oval shaped tumor cells with hypocellular and hypercellular area within a ropey collagenous stroma. Pericytic vascular pattern are seen. The tumor cells are positive for CD34, BCL2, CD99 and STAT 6 with patchy CK AE1/AE3 positivity, thus the impression of solitary fibrous tumor (SFT) given. Conclusion Our case highlights the importance of considering Doege-Potter syndrome in a patient with SFT and hypoglycemia. Non islet cell tumor hypoglycaemia (NICTH) is the main clinical characteristic of Doege–Potter syndrome. It occurs in < 5 percent of cases and is primarily seen in large peritoneal/ primary tumor and caused by tumor secretion of large insulin like growth factor II (IGF2) and responded well with high dose steroid

Doege Potter syndrome

Pleuropulmonary solitary fibrous tumor (SFT) infrequently have been associated with paraneoplastic syndromes, most commonly reported is non islet cell tumor hypoglycaemia (Doege Potter Syndrome)

Knowledge, attitude and practice on hygiene of Kampung Sungai Karang Darat residents and its related factors November 2003

Introduction: A cross-sectional study was conducted in September 2003 to evaluate the Knowledge, Attitude and Practice (KAP) level on hygiene of Kampung Sungai Karang Darat residents and its related factors. Methodology: It was a cross-sectional study conducted by a group of year four medical students 2003/2004 from Community Health and Family Medicine posting, Kulliyyah of Medicine, IIUM. Data collection methods included observations and interview-guided questionnaires. Out of the total number of 2620 residents, 304 people aged 18 and above from 200 houses which were randomly selected from 600 houses in that village were surveyed on the KAP of hygiene. We then determined the factors that affect the KAP level, and how it in turn influenced the health status of the respondents, particularly their susceptibility towards hygiene-related diseases. Result: From the statistical analysis, it was found that the mean KAP score of the respondents was 26.42+4.15, on a scale that ranged from 0 to 39 with the lowest KAP score of 14 and the highest KAP score of 36. It was then found that the higher the age of the respondents, the lower the KAP score (p<0.001). Higher socioeconomic status was associated with higher KAP score (occupation (p=0.007), academic level (p<0.001), and income per capita (p<0.001)). Malaysians of non-Pahang origin also had higher KAP score compared to residents of Pahang origin (p<0.001). People living in modern houses had a higher KAP value than those living in traditional houses (p<0.001). Housing quality also had effect on the KAP score (r=+0.665). However, the KAP level was not significantly related to gender difference (p=0.162). Personal hygiene had the lowest mean KAP score, followed by domestic hygiene and then community hygiene. Meanwhile, the highest mean low KAP score were found to have no significant preponderance towards hygiene-related diseases (p=0.409) Conclusion: Overall, the KAP level on hygiene of residents of Kampung Sungai Karang Darat was at a satisfactory level