Abstract
BackgroundRenal cell carcinoma is associated with a wide spectrum of para-neoplastic syndromes, which may be precursors of primary or recurrent disease. Non-metastatic hepatic dysfunction in patients suffering from renal cell carcinoma is known as Stauffer's syndrome. It is associated with the production of cytokines by the tumour, and several biochemical abnormalities, including elevated serum alkaline phosphatase.Case presentationWe describe a 36-year-old woman presenting with various non-specific, systemic disease manifestations, and elevated liver enzymes due to cholestasis as the main laboratory abnormality. Imaging studies showed a solid mass in the left kidney, which, after surgical excision, was identified as renal cell carcinoma. No metastasis was found.ConclusionStauffer syndrome may precede other manifestations of renal cell carcinoma. In case of unexplained abnormal liver function, particularly in presence of systemic symptoms, underlying renal cell carcinoma should be excluded by focused investigations.
Highlights
Renal cell carcinoma is associated with a wide spectrum of para-neoplastic syndromes, which may be precursors of primary or recurrent disease
Since a para-neoplastic manifestation may be the initial clinical presentation in a considerable proportion of patients, its recognition facilitates the early diagnosis of Renal cell carcinoma (RCC) [1,2,3]
In 1961, Stauffer described abnormal liver function tests, hepato-splenomegaly, histologic changes consistent with non-specific hepatitis, and a reversal of these abnormalities after nephrectomy, in patients suffering from RCC [4]
Summary
Renal cell carcinoma (RCC) is associated with an up to 20% prevalence of para-neoplastic syndromes. In absence of liver metastases, occurs in 10 to 15% of RCC, attributed to the production of cytokines from the tumour, including interleukin-6 [5,6]. It is associated with fever, weight loss and an unfavourable prognosis [7]. Cases Journal 2009, 2:49 http://www.casesjournal.com/content/2/1/49 earlier, on the basis of consistent clinical manifestations, elevated thyroid hormones, suppressed concentrations of TSH and positive thyroid peroxidase antibodies, and the patient had since been treated with methimazole She had a history of idiopathic epilepsy treated with phenytoin since the age of 19 years. The serum concentrations of cholestatic liver enzymes have returned to normal
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