Paragonimus kellicotti Presenting With Hemoptysis and a Left Upper Lobe Mass.

A 46-year-old man presented to the thoracic surgery clinic with a 6-month history of cough and hemoptysis refractory to treatment. Examination of specimens from repeated biopsies was nondiagnostic, so the patient underwent video-assisted thoracoscopic left upper lobe wedge resection. Pathologic examination revealed Paragonimus organisms, and the patient was prescribed praziquantel, with resolution of his symptoms. Although Paragonimus infections are common in Asia, they are rare in the United States despite P kellicotti being endemic. Clinicians should have a high index of suspicion for patients presenting with unusual lung symptoms in endemic areas to avoid prolonged evaluations with potentially unnecessary diagnostic modalities.

Hypoglycemia with a large retroperitoneal mass - Case report.

INTRODUCTION: Retroperitoneal sarcomas have rarely been reported to secrete insulin-growth factor II (IGF-II) and produce an enigmatic hypoglycemia. IGF-II-secreting sarcomas represent an extremely rare subset of soft tissue tumors, and reports are limited to a handful of cases. PRESENTATION OF CASE: The authors present the case of hypoglycemia due to an IGF-II-secreting retroperitoneal sarcoma that was successfully treated by complete surgical resection. This report describes the diagnosis and management of this rare syndrome with 1-year follow-up and a review of the literature. DISCUSSION: Steroid and growth hormone therapies also have efficacy to treat this hypoglycemia in some patients. However, outcomes appear better if combined with surgical resection. CONCLUSIONS: The findings of this case report and review of the literature support a primary role for complete tumor resection to address tumor-induced hypoglycemia.