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2018 ; 2018
(ä): 4215041
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English Wikipedia
Metastatic Renal Cell Carcinoma Presenting as Prolonged Pyrexia and Stauffer s
Syndrome: Can a Routine Ultrasound Scan Fail to Detect a Renal Cell Carcinoma?
#MMPMID30057844
Fonseka CL
; Kariyawasam AGTA
; Singhapura SDAL
; Singhapura SAGL
; de Silva CM
; Kanakkahewa TE
; Senarathna IGTM
; Bodinayake CK
Case Rep Radiol
2018[]; 2018
(ä): 4215041
PMID30057844
show ga
BACKGROUND: Prolonged pyrexia and weight loss are recognised paraneoplastic
manifestations of renal cell carcinoma (RCC). Stauffer's syndrome is a rarely
described paraneoplastic manifestation, which is described early in the course of
RCC. We report a patient who presented with unresolving fever with multiple
pulmonary opacities with biochemical evidence of hepatic choleastasis and was
later diagnosed to have metastatic RCC with Stauffer's syndrome. CASE
PRESENTATION: We report a 54-year-old female who was investigated for a poorly
resolving fever and recent weight loss for two months. During her course of
illness, she developed bilateral multiple opacifications in the chest radiograph
with negative pyogenic, mycobacterial microbiological studies. Despite
intravenous antibiotics, her fever continued. She was found to have elevated
alkaline phosphatase and gamma-glutamyl transferase and she underwent imaging
with ultrasound scan of abdomen twice, which did not reveal demonstrable
abnormalities. Later, contrast CT of abdomen and chest was performed and detected
a renal cell carcinoma of the right upper pole of the kidney with multiple lung
metastases, which was concluded as a metastatic RCC with paraneoplastic
Stauffer's syndrome. CONCLUSION: Prolonged pyrexia with loss of weight and
Stauffer's syndrome could be features to suggest renal cell carcinoma in the
absence of positive microbiological studies. Isoechoic RCC could be missed in
routine ultrasonography. When a RCC is suspected in the setting of a pyrexia of
unknown origin, ultrasound with doppler or a contrast CT should be requested to
aid diagnosis.