title: A case of paraneoplastic nephrotic syndrome in a patient with ovarian carcinoma.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Yong Tai
authors.initials: YT
authors.lastname: Kim
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Rha
authors.forename: Chi Young
authors.initials: CY
authors.lastname: Shim
authors.forename: Joo Hyuk
authors.initials: JH
authors.lastname: Sohn
authors.forename: Chul
authors.initials: C
authors.lastname: Kim
authors.forename: Nae Choon
authors.initials: NC
authors.lastname: Yu
authors.forename: Hyun Cheol
authors.initials: HC
authors.lastname: Chung
authors.forename: Joo Hang
authors.initials: JH
authors.lastname: Kim
authors.forename: Dae Suk
authors.initials: DS
authors.lastname: Han
authors.forename: Byung Soo
authors.initials: BS
authors.lastname: Kim
authors.forename: Jae Kyung
authors.initials: JK
authors.lastname: Roh
mesh_terms: 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