To the Editor. —
Renal cell carcinoma is known to be associated with reversible hepatic dysfunction accompanied by hepatosplenomegaly in the absence of metastatic disease to the liver or spleen.1,2 The syndrome has been reported to cause elevations in the levels of serum alkaline phosphatase, serum bilirubin, aspartate aminotransferase, alanine aminotransferase, and serum L-lactate dehydrogenase. A patient recently presented with the syndrome and elevation of the serum γ-glutamyl-transferase (GGT) level, a test that was introduced subsequent to previously reported cases.
Report of a Case.—
A 69-year-old woman with a history (18 years ago) of renal cell carcinoma and left nephrectomy came to the emergency department complaining of severe epigastric pain, weight loss, and early satiety. There was no history of alcohol abuse, drug or medication use, blood transfusion, or recent travel. Physical examination revealed an epigastric mass and splenomegaly. Serum chemistry values were as follows: L-lactate dehydrogenase, 375 U/L;
Cardo LJ. γ-Glutamyltransferase in Hypernephroma. JAMA. 1991;265(14):1825-1826. doi:10.1001/jama.1991.03460140053017