"Non-classical" or "atypical" variant of Stauffer syndrome in a patient with clear cell renal carcinoma: a case report
DOI:
https://doi.org/10.52784/27112330.143Keywords:
Stauffer syndrome, paraneoplastic syndrome, renal cell carcinoma, jaundice, cholestasis, transaminases, alkaline phosphatase.Abstract
The paraneoplastic manifestation known as Stauffer syndrome has an atypical presentation, characterized by jaundice and intrahepatic cholestasis. We present the case of a 53-year-old patient, with a history of a right renal mass with a planned surgical resection, who developed abdominal pain in the right upper quadrant and jaundice. Upon admission, hepatosplenomegaly, elevated bilirubin, at the expense of direct bilirubin, alkaline phosphatase and elevated transaminases were documented. Intra and extrahepatic bile ducts obstruction were ruled out. There were no documented metastases or focal lesions at the level of the parenchyma, or lesions of vascular etiology that could explain the condition. Hepatitis B, C and HIV infection were also ruled out, and a probable Stauffer syndrome was considered. In-hospital nephrectomy was performed, with subsequent pathology compatible with clear cell carcinoma. After the procedure, liver biochemistry was normalized and jaundice was corrected. It is important to recognize that liver involvement in the context of neoplasms is not only attributed to distant metastases but to the existence of paraneoplastic syndromes as determining factors.
Downloads
References
Stauffer MH. Nephrogenic hepatomegaly. Gastroenterology 1961;40:694.
Palapattu GS, Kristo B, Rajfer J. Paraneoplastic syndromes in urologic malignancy: the many faces of renal cell carcinoma. Rev Urol 2002;4:163-170.
Souadjian JV, Susset J, Longpré B, Lebel E, Marcoux AJ, Côté R. [Stauffer's syndrome: reversible hepatic dysfunction in a patient with hypernephroma]. Can Med Assoc J 1971;105:394-396.
Giannakos G, Papanicolaou X, Trafalis D, Michaelidis I, Margaritis G, Christofilakis C. Stauffer's syndrome variant associated with renal cell carcinoma. Int J Urol 2005;12:757-759. https://doi.org/10.1111/j.1442-2042.2005.01149.x.
Tomadoni A, García C, Márquez M, Ayala JC, Prado F. Stauffer's syndrome with jaundice, a paraneoplastic manifestation of renal cell carcinoma: a case report. Arch Esp Urol 2010;63:154-156.
Sharma N, Darr U, Darr A, Sood G. Stauffer syndrome: A comprehensive review of the icteric variant of the syndrome. Cureus 2019;11:e6032. https://doi.org/10.7759/cureus.6032.
Ateş İ, Kaplan M, Yılmaz N. A Stauffer's syndrome variant associated with renal cell carcinoma and thrombocytopenia. Afr J Urol 2015;21:217-219. https://doi.org/https://doi.org/10.1016/j.afju.2015.05.005.
Mazokopakis EE, Papadakis JA, Kofteridis DP. Unusual causes of intrahepatic cholestatic liver disease. World J Gastroenterol 2007;13:1879-1882. https://doi.org/10.3748/wjg.v13.i12.1879.
Karakolios A, Kasapis C, Kallinikidis T, Kalpidis P, Grigoriadis N. Cholestatic jaundice as a paraneoplastic manifestation of prostate adenocarcinoma. Clin Gastroenterol Hepatol 2003;1:480-483. https://doi.org/10.1016/s1542-3565(03)00227-1.
Fontes-Sousa M, Magalhães H, da Silva FC, Maurício MJ. Stauffer's syndrome: A comprehensive review and proposed updated diagnostic criteria. Urol Oncol 2018;36:321-326. https://doi.org/10.1016/j.urolonc.2018.01.019.
Bardia A, Thompson CA, Podratz KC, Okuno SH. Bizarre big belly ball: intraabdominal abscess mimicking stauffer syndrome secondary to uterine leiomyosarcoma. Eur J Gynaecol Oncol 2007;28:134-136.
Yalçin S, Kars A, Sökmensüer C, Atahan L. Extrahepatic Hodgkin's disease with intrahepatic cholestasis: report of two cases. Oncology 1999;57:83-85. https://doi.org/10.1159/000012005.
Sharara AI, Panella TJ, Fitz JG. Paraneoplastic hepatopathy associated with soft tissue sarcoma. Gastroenterology 1992;103:330-332. https://doi.org/10.1016/0016-5085(92)91131-m.
Jangouk P, Hashash JG. An unusual cause of painless jaundice. Renal cell carcinoma (Stauffer syndrome). Gastroenterology 2014;146:913, 1138. https://doi.org/10.1053/j.gastro.2013.12.038.
Bhangoo MS, Cheng B, Botta GP, Thorson P, Kosty MP. Reversible intrahepatic cholestasis in metastatic prostate cancer: An uncommon paraneoplastic syndrome. Mol Clin Oncol 2018;8:609-612. https://doi.org/10.3892/mco.2018.1564.
Blay JY, Rossi JF, Wijdenes J, Menetrier-Caux C, Schemann S, Négrier S, et al. Role of interleukin-6 in the paraneoplastic inflammatory syndrome associated with renal-cell carcinoma. Int J Cancer 1997;72:424-430. https://doi.org/10.1002/(sici)1097-0215(19970729)72:3<424::aid-ijc9>3.0.co;2-r.
Álvarez-Umaña SV, Soto-Cerdas JV, Quirós-Quirós VD, González-Sáenz M. Hepatotoxicidad por sustancias de origen botánico. Med Leg Costa Rica 2016;33:85-95.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Hepatología’s authorship policy is based on the criteria established by the International Committee of Medical Journal Editors (ICMJE) to credit a person for their work while assigning them responsibility for its publication.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
