An Unusual Case of Cholestatic Hepatitis

Abstract

resection of the primary tumor. Here we present an unusual case of non-metastatic hepatic dysfunction secondary to renal cell carcinoma, also known as Stauffer's syndrome, in a 55-year old patient who presented with liver synthetic dysfunction and notable hyperbilirubinemia. Unlike earlier reports, the icteric variant of Staffer's syndrome has been emerging as the predominantly reported variant in the recent literature. Moreover, poor correlation between the severity of hepatic dysfunction and the liver biopsy findings was noted. The variable and non-specific presenting symptoms and signs as well as the need for extensive evaluation for abnormal liver chemistry usually results in a delay in the diagnosis of the primary tumor. Therefore, physicians need to be familiar with this clinical entity as a possible reversible etiology of liver chemistry abnormalities in patients with renal and other solid tumors as this may guide further investigations, lead to earlier diagnosis and treatment of the primary tumor, and ultimately improve outcomes. INTRODUCTIONNon-metastatic hepatic dysfunction secondary to renal cell carcinoma, also known as Stauffer's syndrome, was first described by Stauffer in 1961 [1] . The pathophysiology has not been completely elucidated so far. Surgical resection of the primary tumor is characteristically associated with reversal of liver chemistry abnormalities [2] . CASE PRESENTATIONA 55-year-old Caucasian male with a past medical history of type 2 diabetes mellitus and benign prostatic hyperplasia presented to the emergency room with the chief complaint of worsening abdominal ABSTRACTRenal cell carcinoma can present with a variety of paraneoplastic syndromes. Reversible hepatic dysfunction in the setting of nonmetastatic renal cell carcinoma is a rare paraneoplastic phenomenon that was first described by Stauffer in 1961. This clinical entity is characterized by reversal of liver chemistry abnormalities after CASE REPORT