Gastrointestinal stromal tumor with nephrotic syndrome as a paraneoplastic syndrome: a case report

Abstract

IntroductionParaneoplastic syndromes are disorders associated with clinical signs and symptoms caused by substances produced by malignant disease and are not directly related to the physical effects of a primary or metastatic tumor. We describe a patient with gastrointestinal stromal tumor of the stomach accompanied by nephrotic syndrome as paraneoplastic syndrome in whom symptomatic treatment was ineffective. Nephrotic syndrome caused by gastrointestinal stromal tumors is quite rare, and to the best of our knowledge this is the first time that such a case has been documented.Case presentationWe describe a 69-year-old Asian woman with a gastrointestinal stromal tumor of the stomach accompanied by paraneoplastic syndrome. The patient had severe hypoalbuminemia and proteinuria, which were apparently attributed to a gastrointestinal stromal tumor. After preoperative treatment for hypoalbuminemia, the tumor was resected and nephrotic syndrome improved. Two years after her operation, she is still alive with neither tumor recurrence nor nephrotic syndrome.ConclusionPatients with refractory nephrotic syndrome caused by a malignant tumor should be treated aggressively, even if they are in poor general condition. Otherwise, the opportunity for potentially curative surgery may be missed.

Consumptive Hypothyroidism: An Unusual Paraneoplastic Manifestation of a Gastric Gastrointestinal Stromal Tumor

“…Although rare, paraneoplastic syndromes have been described with GIST. These include autoimmune haemolytic anaemia, hypoglycaemia, hyponatremia, nephrotic syndrome, headache and diplopia [3][4][5][6][7].…”

Membranous nephropathy and cancer in the era of PLA2R testing

“…The relationship between MN and malignancy is strengthened by case reports of nephrotic syndrome or MN that went into remission after carcinoma treatment, either via resection of the tumor, chemotherapy, or radiation therapy. 9,10 , 18–22 In the study by Timmermans et al, 15 proteinuria resolved with resection of the cancer in two-thirds of the patients who had both diseases. In Lefaucheur et al’s 5 study, MN went into remission in six patients whose cancer was in remission.…”

Síndromes paraneoplásicos en tumores gastrointestinales. Revisión de tema

“…Los más frecuentes son el cáncer gástrico -en el 25% de los casos-, el pulmonar -en el 15% de los casos-y el linfoma -en el 10% de los casos- (56). Entre todos los pacientes con cáncer, el 50% de los casos de síndrome nefrótico paraneoplásico se asocian con cáncer pulmonar y gastroinestinal (57,58).…”

“…La principal lesión renal subyacente es la glomerulonefritis membranosa (57,58). La resección quirúrgica del tumor mejora en hasta el 78% de los pacientes, por lo que está indicada incluso si la condición del paciente es mala (56).…”