Paraneoplastic Cholestasis Associated With Ovarian Dysgerminoma

Obstet Gynecol. 2015 Aug;126(2):431-434. doi: 10.1097/AOG.0000000000000699.

Abstract

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.

Case: 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.

Conclusion: Paraneoplastic syndrome should be considered in the differential diagnosis for patients with ovarian malignancies who present with cholestasis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cholestasis* / diagnosis
  • Cholestasis* / etiology
  • Cholestasis* / physiopathology
  • Cytoreduction Surgical Procedures / methods*
  • Dysgerminoma* / complications
  • Dysgerminoma* / pathology
  • Dysgerminoma* / surgery
  • Female
  • Humans
  • Liver Function Tests / methods
  • Lymph Node Excision / methods
  • Lymphatic Metastasis
  • Neoplasm Staging
  • Neoplasms, Germ Cell and Embryonal* / complications
  • Neoplasms, Germ Cell and Embryonal* / pathology
  • Neoplasms, Germ Cell and Embryonal* / surgery
  • Ovarian Neoplasms* / complications
  • Ovarian Neoplasms* / pathology
  • Ovarian Neoplasms* / surgery
  • Ovariectomy / methods*
  • Paraneoplastic Syndromes* / diagnosis
  • Paraneoplastic Syndromes* / etiology
  • Paraneoplastic Syndromes* / physiopathology
  • Tomography, X-Ray Computed
  • Treatment Outcome

Supplementary concepts

  • Ovarian Germ Cell Cancer