title: Stauffer's syndrome as a prominent manifestation of renal cancer: a case report.
abstract: BACKGROUND
  Renal cell carcinoma is associated with a wide spectrum of para-neoplastic syndromes, which may be precursors of primary or recurrent disease. Non-metastatic hepatic dysfunction in patients suffering from renal cell carcinoma is known as Stauffer's syndrome. It is associated with the production of cytokines by the tumour, and several biochemical abnormalities, including elevated serum alkaline phosphatase.
  
  
  METHODS
  We describe a 36-year-old woman presenting with various non-specific, systemic disease manifestations, and elevated liver enzymes due to cholestasis as the main laboratory abnormality. Imaging studies showed a solid mass in the left kidney, which, after surgical excision, was identified as renal cell carcinoma. No metastasis was found.
  
  
  CONCLUSIONS
  Stauffer syndrome may precede other manifestations of renal cell carcinoma. In case of unexplained abnormal liver function, particularly in presence of systemic symptoms, underlying renal cell carcinoma should be excluded by focused investigations.
authors.affiliation: Department of Clinical Therapeutics, University of Athens, School of Medicine, "Alexandra" Hospital, Athens, Greece. jnanas@ath.forthnet.gr.
authors.forename: Georgios P
authors.initials: GP
authors.lastname: Kranidiotis
authors.forename: Paraskevi T
authors.initials: PT
authors.lastname: Voidonikola
authors.forename: Meletios K
authors.initials: MK
authors.lastname: Dimopoulos
authors.forename: Maria I
authors.initials: MI
authors.lastname: Anastasiou-Nana