A case of paraneoplastic nephrotic syndrome in a patient with ovarian carcinoma.
Nephrotic syndrome is a rare manifestation of malignancy associated with paraneoplastic syndrome. Paraneoplastic nephrotic syndrome has been reported in various malignancies: malignant lymphoma, colon cancer, lung cancer and prostate cancer. However, an ovarian carcinoma associated with nephrotic syndrome has rarely been reported. Only six cases of ovarian carcinoma associated paraneoplastic nephrotic syndrome has been reported worldwide, but no cases have been reported in Korea. Here, we report a case of paraneoplastic nephrotic syndrome in a patient with an ovarian carcinoma. The patient presented with ascites, proteinuria and hypoalbuminemia. An initial computed tomography (CT) scan and ultrasonography evaluations showed no specific findings suggestive of an ovarian tumor. Despite treatment for nephrotic syndrome, the symptoms became more aggravated. There after, follow up evaluation at Yonsei University Medical Center, including serum CA 125, pelvis MRI and peritoneal fluid examination were performed. On the pelvis MRI, a left ovarian mass was detected with an ascitic fluid collection. The serum CA 125 level was elevated to 2211 U/ml. The peritoneal fluid cytological examination showed malignant cells suggestive of an ovarian carcinoma. Combination chemotherapies including paclitaxel plus carboplatin, topotecan plus gemcitabine and oxaliplatin plus capecitabine were administered to the patient, and complete remission was achieved on image and tumor marker studies. There was complete recovery from the nephrotic syndrome with no evidence of ascites and proteinuria. These findings suggest that nephrotic syndrome caused by paraneoplastic syndrome can be resolved only after the complete control of the underlying malignancy.
Kim
Yong Tai
YT
Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
Rha
Sun Young
SY
Shim
Chi Young
CY
Sohn
Joo Hyuk
JH
Kim
Chul
C
Yu
Nae Choon
NC
Chung
Hyun Cheol
HC
Kim
Joo Hang
JH
Han
Dae Suk
DS
Kim
Byung Soo
BS
Roh
Jae Kyung
JK
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications* / Q000188:drug therapy; D010051:Ovarian Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010257:Paraneoplastic Syndromes / Q000150:complications* / Q000188:drug therapy; D012074:Remission Induction; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed