Paraneoplastic Cholestasis in Prostate Carcinoma: A Case Report and Review of the Literature

Abstract

1756ntrahepatic cholestasis is a rare manifestation of paraneoplastic syndrome and has been reported to be associated with various malignancies. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Systemic and/or local intrahepatic proinflammatory cytokines are assumed to inhibit hepatocellular bile secretion. There is evidence that those cytokines are potent inhibitors of hepatobiliary transporter gene expression, resulting in hyperbilirubinemia and cholestasis. 15 Prostate carcinoma associated with cholestasis may be due to mechanical bile duct obstruction by the liver metastasis 16 or enlarged lymph Paraneoplastic Cholestasis in Prostate Carcinoma: A Case Report and Review of the Literature A AB BS S T TR RA AC CT T In tra he pa tic cho les ta sis is a ra re ma ni fes ta ti on of pa ra ne op las tic syndro me and has been re por ted to be as so ci a ted with va ri o us ma lig nan ci es. In tra he pa tic cho les ta sis wit ho ut a mec hani cal obs truc ti on has be en pre vi o usly re por ted in only thre e pros ta te car ci no ma ca ses in Eng lish li te ra tu re. In this re port, we des cri bed a new ca se of pa ra ne op las tic in tra he pa tic cho les ta sis in a pati ent with pros ta te car ci no ma tre a ted only with bi la te ral orc hi ec tomy. We al so dis cus sed the mecha nisms of cho les ta sis in pros ta te car ci no ma in the light of the per ti nent li te ra tu re. Pa ra ne op las tic cho les ta sis sho uld be kept in mind in the ab sen ce of bi li ary tract obs truc ti on and he pa tic in vol vement in pros ta te car ci no ma. Pa ti ents with unexp la i ned cho les ta sis sho uld be in ves ti ga ted for a possib le pa ra ne op las tic syndro me. Pa ra ne op las tic cho les ta sis re sol ves fol lo wing orc hi ec tomy in pros ta te car ci no ma ca ses.K Ke ey y W Wo or rd ds s: : Cho les ta sis, in tra he pa tic; pa ra ne op las tic syndro mes; pros ta tic ne op lasms Ö ÖZ ZE ET T İntra he pa tik ko les taz, pa ra ne op las tik sendromun na dir bir gös ter ge si olup çe şit li ma lig ni teler le bir lik te li ği bil di ril miş tir. Pros tat kan se rin de me ka nik obs trük si yon ol mak sı zın ge li şen in trahe pa tik ko les taz, İngi liz li te ra tü rün de da ha ön ce sa de ce üç ol gu da su nul muş tur. Bu ra da, sa de ce bi la te ral or şi ek to mi ile pa ra ne op las tik in tra he pa tik ko les ta zı te da vi edi len, pros tat kan ser li ye ni bir ol gu sun duk. Ay rı ca, bu ko nu ile il gi li li te ra tür ler eş li ğin de pros tat kan se rin de ko les ta zın me ka nizma la rı nı da tar tış tık. Pa ra ne op las tik ko les tazın, pros tat kan se rin de he pa tik tu tu lum ve bi li yer obstrük si yon ol mak sı zın ge li şe bi le ce ği akıl da tu tul ma lı dır. Açık la na ma yan ko les taz lı has ta la r da pa ra ne op las tik sen drom araş tı rıl ma lı dır. Pa ra ne op las tik ko les taz pros tat kan ser li va ka lar da or şi ekto mi yi ta ki ben ge ri le mek te dir. İbrahim ERTUĞRUL, MD,