Idiopathic cholestatic jaundice may be a paraneoplastic manifestation of underlying malignancy: a case of prostate cancer

A 68-year-old male was admitted to our hospital because of jaundice. Laboratory examinations revealed elevated total bilirubin (23.4 mg/dl) and hepatobiliary enzymes levels. Abdominal ultrasonography and computed tomography showed no abnormal finding in the liver and biliary ducts. Abdominal imaging...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2014-06, Vol.7 (3), p.278-282
Main Authors: Okano, Akihiro, Ohana, Masaya, Kusumi, Fusako
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adenocarcinoma - complications
Adenocarcinoma - diagnosis
Aged
Case Report
Colorectal Surgery
Gastroenterology
Hepatology
Humans
Jaundice, Obstructive - etiology
Male
Medicine
Medicine & Public Health
Paraneoplastic Syndromes - etiology
Prostatic Neoplasms - complications
Prostatic Neoplasms - diagnosis
Surgical Oncology
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Summary:A 68-year-old male was admitted to our hospital because of jaundice. Laboratory examinations revealed elevated total bilirubin (23.4 mg/dl) and hepatobiliary enzymes levels. Abdominal ultrasonography and computed tomography showed no abnormal finding in the liver and biliary ducts. Abdominal imaging examinations revealed a prostate tumor, and paraaortic and iliac lymph nodes enlargement. An elevated prostate-specific antigen (PSA) level of 15,018.0 ng/ml, followed by a positive prostate biopsy, confirmed prostate cancer. Histological examination of the liver biopsy showed non-specific inflammation of the portal area and sinusoid. We regarded the cholestatic jaundice as a paraneoplastic manifestation of the prostate cancer because of parallel dramatic decline of total bilirubin, hepatobiliary enzymes, and PSA levels after the initiation of anti-androgen treatment to the prostate cancer. Paraneoplastic syndrome should be included in the differential diagnosis of idiopathic cholestasis.
ISSN:1865-7257
1865-7265
DOI:10.1007/s12328-014-0484-4