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November 1977

Intermittent Cholestatic Jaundice and Nonmetastatic Prostatic Carcinoma

Author Affiliations

From the Gastrointestinal Section, Departments of Medicine and Surgery, Brooklyn Veterans Administration Hospital (Drs Reddy, Grosberg, and Wapnick); and State University of New York, Downstate Medical Center, Brooklyn (Dr Wapnick).

Arch Intern Med. 1977;137(11):1616-1618. doi:10.1001/archinte.1977.03630230088024

Hepatomegaly and abnormal liver function can occur in nonmetastatic malignancies. A patient with metastatic prostatic adenocarcinoma that had spared the liver and extrahepatic biliary tree is described. He had puzzling episodes of jaundice for a period of 2 1/2 years. The results of appropriate investigations and an exploratory laparotomy performed during the patient's four antemortem hospitalizations were indicative of "recurrent intrahepatic cholestasis," the cause of which remained an enigma even after exploratory laparotomy. At autopsy, no evidence of hepatic metastases or extrahepatic biliary obstruction was found. Alcohol, hepatotoxic drugs, toxins, viral and chronic active hepatitis, hemolysis, and extrahepatic biliary obstruction were eliminated as causes of the jaundice. We believe that the intermittent intrahepatic cholestasis is one of the nonmetastatic manifestations (nonmetastatic hepatopathy of malignancy) of the prostatic adenocarcinoma.

(Arch Intern Med 137:1616-1618, 1977)