The Effect of Embolisation/Nephrectomy for Renal Carcinoma on the Paraneoplastic Syndromes
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. 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.
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.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.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.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.Miscellaneous syndromes
including mucin secretion and salt losing nephritis
KeywordsRenal Cell Carcinoma Renal Tumour Renal Carcinoma Paraneoplastic Syndrome Loin Pain
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