Paraneoplastic Cholestasis Associated With Ovarian Dysgerminoma.
BACKGROUND
Paraneoplastic syndromes are disorders caused by cancer that are not a direct result of the cancer mass itself or metastases to the affected organ. Paraneoplastic cholestasis is described with lymphoma and renal cell carcinoma. Unlike ovarian carcinoma, paraneoplastic syndromes are rarely seen in dysgerminoma.


METHODS
A 22-year-old woman presented with 3 days of jaundice and lower abdominal pain. Liver tests revealed marked cholestasis and high alkaline phosphatase and bilirubin levels. Imaging showed a normal-appearing liver, a large multiseptated ovarian cystic mass, ascites, and paraaortic lymphadenopathy. Debulking surgery found a dysgerminoma with metastasis to aortic lymph nodes. Hepatic dysfunction completely resolved within 4 weeks of surgery.


CONCLUSIONS
Paraneoplastic syndrome should be considered in the differential diagnosis for patients with ovarian malignancies who present with cholestasis.
Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and the Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.
Kelvin E
KE
Yeh
Peter S
PS
Marcus
Tse-Ling
TL
Fong
D000328:Adult; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D004407:Dysgerminoma / Q000150:complications / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008111:Liver Function Tests / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications / Q000473:pathology / Q000601:surgery; D010051:Ovarian Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D010052:Ovariectomy / Q000379:methods*; D010257:Paraneoplastic Syndromes / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome