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Renal Cell Carcinoma with Polycythemia | ||
| Al- Anbar Medical Journal | ||
| Article 10, Volume 17, Issue 1, 2021, Pages 41-43 PDF (467.22 K) | ||
| Document Type: Case reports | ||
| DOI: 10.33091/amj.2021.171065 | ||
| Authors | ||
| Asaad I Othman .* 1; Nabeel M Al-Hamamy .1; Saud Al-Jumaly .2 | ||
| 1Department of Surgery (Urology), Al-Jumhory Teaching hospital, Nineveh Health Directorate, Mosul, Nineveh, Iraq | ||
| 2Department of Surgery (Urology), Al-Salam Teaching hospital, Nineveh Health Directorate, Mosul, Nineveh, Iraq | ||
| Abstract | ||
| Renal cell carcinoma (RCC) is the most common renal tumor and participates in about 80-85%of primary renal tumors. It is usually diagnosed incidentally during the evaluation for othermedical problems; or it may be presented with gross hematuria, loin mass or pain. However, itinfrequently presents as a paraneoplastic syndrome (PNS) which includes, hypertension, hypercalcemia, and abnormal liver function. A 75-year-old gentleman presented with an incidentalleft renal mass following the evaluation of the left loin pain with headache and dizziness. Thepatient had a history of hypertension for 10 years on control medical therapy and no history ofsmoking or chronic obstructive airway disease. The complete blood picture was showed a markedelevation in hemoglobin 21.7 g/dl and hematocrit level 65%. Ultrasound was showed left renalmass and a computerized tomography scan was showed the enhancement in the left renal masspicture suggestive of RCC. After phlebotomy of 2 units of blood, the patient underwent radicalnephrectomy, then the histopathology was reported clear cell type RCC Fuhrman nuclear gradingsystem II. At 2 months following surgery, the patient’s hemoglobin level and hematocrit werereturned to normal. The pathogenesis of PNS may be due to an abnormal immune system responseto a cancerous cell. There is a wide range of the PNS concerning RCC including non-specificconstitutional features for example; cachexia, weight loss, and fever, and specific metabolic andbiochemical disorders (i.e. hypercalcemia, non-metastatic hepatic dysfunction, amyloidosis, etc.).PNS is often unrecognized but polycythemia should be considered important biomarkers in RCC,therefore, it can be used as a tumor marker in the diagnosis and follow-up of the patient after surgery. | ||
| Keywords | ||
| Renal cell carcinoma; polycythemia; kidney; Hematocrit | ||
| References | ||
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