Doege-Potter syndrome by malignant solitary fibrous tumor of the liver: A case report and review of literature

BACKGROUND Solitary fibrous tumor of the liver (SFTL) is a rare occurrence with a low number of cases reported in literature. SFTL is usually benign but, 10%-20% cases are reported to be malignant with a tendency to metastasize. The majority of malignant SFTL cases are associated with a paraneoplastic hypoglycaemia defined as Doege-Potter syndrome. Surgery is the best therapeutic treatment, however, long- life follow-up is recommended. CASE SUMMARY A 74-year-old man, was admitted to the emergency department after a syncopal episode with detection of hypoglycaemia resistant to medical treatment. The computed tomography revealed a solid mass measuring 15 cm of the left liver. An open left hepatectomy was performed with complete resection of tumor. Histopathological analyses confirmed a malignant SFTL. CONCLUSION Large series with long-term follow-up have not been published neither have clinical trials been undertaken. Consequently, the methodical long-term followup of surgically treated SFTLs is strongly recommended.

Intervention effect of Zhuangfang Rugan Huaxian Granules on CCl_(4)compound factor‑induced liver fibrosis rat model and its effect on the expression ofα‑SMA and E‑Cadherin

Objective:To study the intervention effect of Zhuangfang Soft Liver and Fibrous Granules on CCl_(4)compound factor-induced liver fibrosis rat model and its effect onα-SMA and E-Cadherin protein expression.Methods:Forty-eight male Wistar rats were randomly divided into a blank group,a pathological model group and a group of 16 rats in each group.The rats in the pathological model group and the pellet group were injected subcutaneously with 40%carbon tetrachloride(CCl_(4))oil combined with peanut oil to establish an animal model of rat liver fibrosis,and the pellets were administered by gavage three times a week for 8 weeks from the 5th week.The expression of oxidative stress oxidase dismutase(SOD)and malondialdehyde(MDA)was detected by enzyme-linked immunoassay(ELISA),and the expression ofα-smooth muscle actin(α-SMA)and E-calmodulin(E-Cadherin)was detected by RT-PCR andWestern Blot.expression.Results:Compared with the blank group,the serum ALT and AST levels of the rats in the pathological model group were significantly increased,and the serum ALT and AST levels of the rats in the soft liver and fibrous pellet group were significantly decreased(P<0.001).In the pathological model group,the lobular structure of liver tissue was mutilated and numerous liver fibrous tissues were abnormally proliferated,and the collagen fibers formed by the proliferation were confluent into dense fibrous intervals,thus turning into pseudolobular structure,and a large number of fatty degenerated hepatocytes of different shapes and sizes appeared inside the pseudolobular structure,and the diffuse infiltration of inflammatory cells was significant.Compared with the pathological model group,the degree of destruction of hepatic lobular structure was significantly reduced in the LBP group,and there were different degrees of proliferation of collagen fibrous tissue concentrated in the area from the central vein to the confluent area,and the fibrous septum was relatively loose,with a small amount of inflammatory cell infiltration,and the degree of infiltration was reduced compared with the pathological model group.Compared with the pathological model group,the SOD level was significantly higher in the group of liver softener and fibrous pellets compared with the pathological model group and the blank group(P<0.001),the MDA level was significantly lower in the group of liver softener and fibrous pellets compared with the pathological model group(P<0.001),the expression level ofα-SMA was significantly lower in the group of liver softener and fibrous pellets(P<0.001),and the expression level of E-Cadherin was significantly higher in the group of liver softener and fibrous pellets(P<0.001).Conclusion:Soft Liver Fibro Pellets can effectively inhibit liver fibrous tissue proliferation and reduce the serum ALT and AST levels in rats with CCl_(4)combined with peanut oil compound solution induced liver fibrosis,and its anti-liver fibrosis mechanism may be through protecting liver function,reducing the level of oxidative stress,down-regulating the expression ofα-SMA protein,up-regulating the expression of E-cadherin protein,and inhibiting epithelial-mesenchymal transition epithelial mesenchymal transformation(EMT)and thus exerting therapeutic effects on CCl_(4)compound-induced hepatic fibrosis in rats.