Sleep-disordered breathing and hypoventilation with a large right-side pleura-based mass

SummaryWe report the case of a 56-year-old female patient with daytime sleepiness, snoring, dyspnea to exertion and hypoglycemia. During the previous months, she had noticed the enlargement of the tongue and the facial characteristics and also development of head lesions. Upon admission, hypoventilation was confirmed (PaO2 61.5 mmHg, PaCO2 50 mmHg). The chest X-ray showed right-side opacity and CT scan presented an intrathoracic, extrapulmonary lesion. Obstructive sleep apnea–hypopnea with severe desaturation episodes was revealed by a sleep study. It was suspected that all the manifestations were due to substances produced by the tumor, and laboratory test showed low levels of insulin, growth hormone and insulin-like growth factor I. Surgical resection of the mass was performed and the diagnosis of solitary fibrous tumor of the pleura (SFTP) was confirmed. We present the case of a patient with SFTP associated with multiple paraneoplastic manifestations.