Renal cell carcinoma is often dubbed the 'internist's tumor' likely because of the many paraneoplaastic syndromes that have been associated with this cancer. The classic triad of "hematuria, flank pain and abdominal mass" as a presentation occurs generally in <10%>
Clinical syndromes....
1. anemia: can have the picture of anemia of chronic disease and precede the diagnosis of RCC.
2. hepatic dysfunction / STAUFFER's Syndrome: may be the result of liver mets but in the case of Stauffers syndrome occurs without any clear evidence of metastases and may be reversed by nephrectomy.
3. Fever: in up to 1/5 of people with additional constitutional symptoms
4. hypercalcemia: from bony mets, increased prostaglandins or PtHRP
5. erythrocytosis
6. thrombocytosis
7. AA amyloidosis
8. other hormonal overproduction....gonadotropins, human chorionic somatomammotropin, an ACTH-like substance, renin, insulin, glucagon
1 comment :
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