A 62-year-old man undergoing evaluation of a right renal mass is found to have elevated serum alkaline phosphatase, raised gamma-glutamyl transferase and prolongation of prothrombin time. Liver biopsy shows nonspecific changes without malignancy, and CT shows no liver metastases. After nephrectomy these abnormalities resolve. This entity is known as:
- A Courvoisier-Terrier sign
- B Stauffer syndrome ✓
- C Budd-Chiari syndrome
- D Zollinger-Ellison syndrome
Correct answer: B. Stauffer syndrome
Explanation
Stauffer syndrome is a non-metastatic hepatic dysfunction associated with renal cell carcinoma, characterised by raised alkaline phosphatase and GGT, prolonged prothrombin time, hypoalbuminaemia and sometimes polyclonal hypergammaglobulinaemia, in the absence of liver metastases or primary hepatic disease. It is attributed to tumour production of interleukin-6 and other cytokines and reverses completely after removal of the primary tumour. Its importance is that it can mimic metastatic liver involvement, but biopsy shows reactive change only.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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