Unspecific Increase of Tumor Markers in a Girl with Nephrotic Syndrome and Ovarian Teratoma

Abstract

Coexistence of nephrotic syndrome and neoplasm is rarely observed in children. We report the diagnostic and therapeutic problems of a 16-year-old female with nephrotic syndrome, ovarian tumor, and increased levels of tumor markers. She was suspected to have paraneoplastic nephrotic syndrome. After ovarian tumor resection, the nephrotic syndrome remission was not observed, while increased tumor marker levels were noted. The patient's final diagnosis was nephrotic syndrome in the course of primary mesangial proliferative glomerulonephritis. In conclusion, nephrotic syndrome in a patient with neoplasia might occur in the course of the primary and nonparaneoplastic glomerulopathy. Elevated serum tumor markers in patients with nephrotic syndrome might be nonspecific because of the stimulation of their production by peritoneal mesothelium, due to transudation to body cavities, that is, ascites.

Ovarian tumor and glomerulopathies: case report and review of the literature

“…Remission of paraneoplastic nephrotic syndrome was described at various times after the resection of tumors, which is connected with immunological dysregulation in the course of neoplastic disease [8]. In terms of ovarian malignancies associated with the NS, only few cases of ovarian tumor, mostly in ademocarcinoma type, presenting as nephrotic syndrome have been reported (Table 2) [2,6,9-19]. Nephrotic syndrome seems to occur irrespective to the ovarian tumor diagnostic time, either before (n=6, from 1 to 32 months), during a relapse 2 years after the first diagnosis (n=1), or simultaneously (n=5).…”

A Case Report of Mediastinal Teratoma in a Pediatric Patient With Nephrotic Syndrome: Paraneoplastic Syndrome or Incidental Finding?

“…NS associated with malignancies is uncommon but well documented, with membranous nephropathy being the most common histologic finding seen in patients with solid tumors and MCD seen more commonly in association with Hodgkin Lymphoma 4 . The literature documents 4 cases of mature teratomas associated with NS, and all 4 cases were associated with ovarian mature teratomas 4–7 . The earliest case published in 1989 describes a 7 year-old female who presented with NS refractory to steroids.…”

“…4 The literature documents 4 cases of mature teratomas associated with NS, and all 4 cases were associated with ovarian mature teratomas. [4][5][6][7] The earliest case published in 1989 describes a 7 year-old female who presented with NS refractory to steroids. She was ultimately found to have an ovarian mass proven to be mature teratoma.…”

“…The last case describes a 16-year-old female with NS and ovarian mature teratoma. Renal biopsy showed mesangial proliferative glomerulonephritis, which responded to tumor resection and cyclosporine 5 …”

The role of serum and urinary carbohydrate antigen 19-9 in predicting renal injury associated with ureteral stone

“…A variety of tissues including the stomach, colon, gall bladder, pancreas, bronchial tree, endometrium, salivary glands and prostate express this marker in normal conditions. [1][2][3] Elevated concentrations of CA19-9 has been reported in nonmalignant conditions such as diabetes mellitus, hepatobiliary or pancreatic complications as well as pulmonary diseases. [4][5][6] Elevation of serum and urinary CA19-9 concentrations has also been reported in several benign urological conditions associated with urinary tract obstruction and hydronephrosis.…”