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The Effect of Embolisation/Nephrectomy for Renal Carcinoma on the Paraneoplastic Syndromes

  • G. D. Chisholm
  • J. R. Hindmarsh
  • T. B. Hargreave
Part of the NATO Advanced Science Institutes Series book series (NSSA, volume 53)

Abstract

The presentation of renal carcinoma may be considered under four headings:-
  1. 1.

    1. A triad of loin pain, mass or haematuria. The components of this triad more commonly present separately; thus haematuria is the presenting feature in 62%, loin pain in 50% and a renal mass in 314% (1). It is unusual for all three features to occur together, and most series report. the triad occurring in approximately only 10–15% of cases.

     
  2. 2.

    2. Metastatic disease. There is almost no organ in the body where a metastasis from renal carcinoma has not been found and in many of these it is the presenting feature of the tumour. A secondary tumour in a bone is the most common site but the diagnosis is not usually made until the biopsy is examined.

     
  3. 3.

    Autopsy findings. It is well recognised that a renal carcinoma may be an incidental finding at autopsy. This incidence is low, <1% of all autopsies (2). However, in a recent study by Hellsten (3) a detailed study of kidneys in an area with a very high autopsy rate showed a much higher incidence than previously reported.

     
  4. 4.
    Paraneoplastic syndromes. A very wide range of clinical and laboratory abnormalities have been described in association with renal tumours (14). The diversity of these abnormalities has led them to be described either as systemic effects or as tumour markers. A classification of these paraneoplastic syndrome is as follows:
    1. 1.
      Non-specific (toxic) syndromes
      • Haematological syndromes (e.g. anaemia

      • Biochemical syndromes (e.g. abnormal liver function tests)

      • Metabolic syndromes (e.g. fever)

      • Immunological syndromes (e.g. neuromyopathy)

       
    2. 2.
      Specific endocrine (humoral) syndromes
      • Hypersecretion of a substance usually associated with the kidney (e.g. renin, erythropoietin)

      • Hypersecretion of substances not normally associated with the kidney (e.g. parathormone, gonadotrophins)

       
    3. 3.
      Miscellaneous syndromes
      • including mucin secretion and salt losing nephritis

       
     

Keywords

Renal Cell Carcinoma Renal Tumour Renal Carcinoma Paraneoplastic Syndrome Loin Pain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    E.N. Riches, I.H. Griffiths, and A.C. Thackray, New growth of kidney and ureter, Brit. J. Urol. 23:297 (1951).PubMedCrossRefGoogle Scholar
  2. 2.
    H.M. Cameron and E. McGoogan, A prospective study of 1152 hospital autopsies: II Analysis of inaccuracies in clinical diagnoses and their significance, J. Pathol. 133:285 (1981).PubMedCrossRefGoogle Scholar
  3. 3.
    S. Hellsten, T. Berge, and L. Wehlin, Unrecognized renal cell carcinoma, in: “Cancer of the Prostate and Kidney,” P.H. Smith and M. Pavone-Macaluso, eds., Plenum Publishing Co., London and New York (1982).Google Scholar
  4. 4.
    G.D. Chisholm, Nephrogenic ridge tumors and their syndromes, Ann. N.Y. Acad. Sci. 230:403 (1974).PubMedCrossRefGoogle Scholar
  5. 5.
    M.H. Stauffer, Nephrogenic hepatosplenomegaly, Gastroenterology 40:694 (1961).Google Scholar
  6. 6.
    J.B. DeKernion, Y. Katsuoka, and K.P. Ramming, Immunology of renal adenocarcinoma, in: “Renal Adenocarcinoma, UICC Technical Report Series,” G. Sufrin and S.A. Beckley, eds., UICC, Geneva, (1980), Vol. 49, p.96.Google Scholar
  7. 7.
    D.J. Johnson, Percutaneous transfemoral renal artery occlusion in the management of advanced renal carcinoma, Henry Ford Hosp. Med. J. 27:92 (1979).Google Scholar
  8. 8.
    D.A. Swanson, S. Wallace, and D.E. Johnson, The role of embolization and nephrectomy in the treatment of metastatic renal carcinoma, Urol. Clin. North Am. 7:719 (1980).PubMedGoogle Scholar
  9. 9.
    J.B. DeKernion, K.P. Ramming, and R.K. Gupta, The detection and clinical significance of antibodies to tumor-associated antigens in patients with renal cell carcinoma, J. Urol. 122:300 (1979).PubMedGoogle Scholar
  10. 10.
    G.D. Chisholm, Clinical and biochemical markers in renal carcinoma, in: “Renal Adenocarcinom, UICC Technical Report Series,” G. Sufrin and S.A. Beckley, eds., UICC, Geneva, (1980), Vol. 49, p. 182.Google Scholar
  11. 11.
    B. Van der Werf Messing, R.O. Van der Heul, and R. Ch. Ledeboer, Prognostic factors in renal cancer, in: “Cancer of the Prostate and Kidney,” P.H. Smith and M. Pavone-Macaluso, eds., Plenum Publishing Co., London and New York (1982).Google Scholar
  12. 12.
    P. McPhedran, S.C. Finch, Y.R. Nemerson, and M.G. Barnes, Alpha-2 globulin “spike” in renal carcinoma, Ann. Intern. Med. 76:439 (1972).PubMedCrossRefGoogle Scholar
  13. 13.
    H.S. Bowman and E.J. Martinez, Fever, anemia and hyperhapto-globinemia: an extrarenal triad of hypernephroma, Ann. Intern. Med. 68:613 (1968).PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1983

Authors and Affiliations

  • G. D. Chisholm
    • 1
  • J. R. Hindmarsh
    • 1
  • T. B. Hargreave
    • 1
  1. 1.Western General HospitalEdinburghScotland

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