title: Gastrointestinal stromal tumor with nephrotic syndrome as a paraneoplastic syndrome: a case report.
abstract: BACKGROUND
  Paraneoplastic syndromes are disorders associated with clinical signs and symptoms caused by substances produced by malignant disease and are not directly related to the physical effects of a primary or metastatic tumor. We describe a patient with gastrointestinal stromal tumor of the stomach accompanied by nephrotic syndrome as paraneoplastic syndrome in whom symptomatic treatment was ineffective. Nephrotic syndrome caused by gastrointestinal stromal tumors is quite rare, and to the best of our knowledge this is the first time that such a case has been documented.
  
  
  METHODS
  We describe a 69-year-old Asian woman with a gastrointestinal stromal tumor of the stomach accompanied by paraneoplastic syndrome. The patient had severe hypoalbuminemia and proteinuria, which were apparently attributed to a gastrointestinal stromal tumor. After preoperative treatment for hypoalbuminemia, the tumor was resected and nephrotic syndrome improved. Two years after her operation, she is still alive with neither tumor recurrence nor nephrotic syndrome.
  
  
  CONCLUSIONS
  Patients with refractory nephrotic syndrome caused by a malignant tumor should be treated aggressively, even if they are in poor general condition. Otherwise, the opportunity for potentially curative surgery may be missed.
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Takane
authors.affiliation: Department of Digestive Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kami-machi, Itabashi-ku, Tokyo 173-8610, Japan. mido-tky@umin.ac.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Midorikawa
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yamazaki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kajiwara
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshida
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kusumi
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
mesh_terms: D000368:Aged; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D009404:Nephrotic Syndrome / Q000209:etiology*; D010257:Paraneoplastic Syndromes / Q000209:etiology*; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D014057:Tomography, X-Ray Computed