Paraneoplastic Phenomena in a Patient With Locally Destructive and Metastatic Renal Cell Carcinoma

Overview

Journal J Prim Care Community Health

Publisher Sage Publications

Specialty Health Services

Date 2018 Sep 19

PMID 30226091

Authors

Allen L Pimienta

Thomas A Billings

Robert G Fish

Affiliations

Soon will be listed here.

Abstract

Renal cell carcinoma (RCC) accounts for approximately 80% of all primary renal neoplasms in United States causing approximately 65 000 new cases of RCC and 14 000 deaths each year. Symptoms of RCC typically include weight loss and night sweats but may also feature paraneoplastic phenomena in advanced stages as well as flank pain, gross hematuria, scrotal varicocele, inferior vena cava pathology, and a palpable abdominal mass. In this article, we present the course of a patient with advanced RCC, from initial presentation through workup and to eventual diagnosis. The case features late-onset symptoms, extensive paraneoplastic phenomena, and significant physical examination findings. We also review the literature available on RCC and critically analyze inefficiencies of the workup retrospectively.

References

Vogelzang N, Stadler W . Kidney cancer. Lancet. 1998; 352(9141):1691-6. DOI: 10.1016/S0140-6736(98)01041-1. View

Siegel R, Miller K, Jemal A . Cancer statistics, 2018. CA Cancer J Clin. 2018; 68(1):7-30. DOI: 10.3322/caac.21442. View

Hidayat K, Du X, Zou S, Shi B . Blood pressure and kidney cancer risk: meta-analysis of prospective studies. J Hypertens. 2017; 35(7):1333-1344. DOI: 10.1097/HJH.0000000000001286. View

Hu J, Mao Y, White K . Renal cell carcinoma and occupational exposure to chemicals in Canada. Occup Med (Lond). 2002; 52(3):157-64. DOI: 10.1093/occmed/52.3.157. View

Donat S, Diaz M, Bishoff J, Coleman J, Dahm P, Derweesh I . Follow-up for Clinically Localized Renal Neoplasms: AUA Guideline. J Urol. 2013; 190(2):407-16. DOI: 10.1016/j.juro.2013.04.121. View

van Poppel H, Da Pozzo L, Albrecht W, Matveev V, Bono A, Borkowski A . A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol. 2010; 59(4):543-52. DOI: 10.1016/j.eururo.2010.12.013. View

Beroukhim R, Brunet J, Di Napoli A, Mertz K, Seeley A, Pires M . Patterns of gene expression and copy-number alterations in von-hippel lindau disease-associated and sporadic clear cell carcinoma of the kidney. Cancer Res. 2009; 69(11):4674-81. PMC: 2745239. DOI: 10.1158/0008-5472.CAN-09-0146. View

Gold P, Fefer A, Thompson J . Paraneoplastic manifestations of renal cell carcinoma. Semin Urol Oncol. 1996; 14(4):216-22. View

Lamb G, Bromwich E, Vasey P, Aitchison M . Management of renal masses in patients medically unsuitable for nephrectomy--natural history, complications, and outcome. Urology. 2004; 64(5):909-13. DOI: 10.1016/j.urology.2004.05.039. View

10.

Tsivian M, Moreira D, Caso J, Mouraviev V, Polascik T . Cigarette smoking is associated with advanced renal cell carcinoma. J Clin Oncol. 2011; 29(15):2027-31. DOI: 10.1200/JCO.2010.30.9484. View

11.

Sidhom O, Basalaev M, Sigal L . Renal cell carcinoma presenting as polymyalgia rheumatica. Resolution after nephrectomy. Arch Intern Med. 1993; 153(17):2043-5. View

12.

Patard J, Leray E, Rioux-Leclercq N, Cindolo L, Ficarra V, Zisman A . Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol. 2005; 23(12):2763-71. DOI: 10.1200/JCO.2005.07.055. View

13.

Ljungberg B, Campbell S, Choi H, Cho H, Jacqmin D, Lee J . The epidemiology of renal cell carcinoma. Eur Urol. 2011; 60(4):615-21. DOI: 10.1016/j.eururo.2011.06.049. View

14.

Pras M, FRANKLIN E, SHIBOLET S, Frangione B . Amyloidosis associated with renal cell carcinoma of the AA type. Am J Med. 1982; 73(3):426-8. DOI: 10.1016/0002-9343(82)90747-1. View

15.

Pantuck A, Zisman A, Belldegrun A . The changing natural history of renal cell carcinoma. J Urol. 2001; 166(5):1611-23. View

16.

Johnson C, Dunnick N, Cohan R, Illescas F . Renal adenocarcinoma: CT staging of 100 tumors. AJR Am J Roentgenol. 1987; 148(1):59-63. DOI: 10.2214/ajr.148.1.59. View

17.

Siegel R, Ward E, Brawley O, Jemal A . Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011; 61(4):212-36. DOI: 10.3322/caac.20121. View

18.

Utz D, Warren M, Gregg J, Ludwig J, KELALIS P . Reversible hepatic dysfunction associated with hypernephroma. Mayo Clin Proc. 1970; 45(3):161-9. View

19.

Thompson R, Ordonez M, Iasonos A, Secin F, Guillonneau B, Russo P . Renal cell carcinoma in young and old patients--is there a difference?. J Urol. 2008; 180(4):1262-6. PMC: 2615196. DOI: 10.1016/j.juro.2008.06.037. View