Hepatic Dysfunction in Renal Cell Carcinoma: Not What You Think?

Excerpt

A 55-year-old Caucasian male, with history of type 2 diabetes mellitus and benign prostatic hyperplasia, was initially evaluated in emergency department with a 2-month history of worsening jaundice, pruritus, and right upper quadrant abdominal pain. His gallbladder had previously been removed. Medications included insulin and tamsulosin. He had a 20 pack-year history of smoking. He denied ever drinking alcohol to excess or using illicit drugs. On presentation, his vital signs were within normal limits. Physical examination revealed only scleral icterus, diffuse skin excoriations on the extremities and torso, and abdominal tenderness to palpation over the right upper quadrant. The liver span was normal; the spleen was not enlarged, and there was no lymphadenopathy or peripheral edema. …