Paraneoplastic proteinuria in papillary renal cell carcinoma; a case report

Abstract

We report a 55-year-old man presented with anemia and weakness, history of flank pain, hematuria and nephrotic syndrome. Spiral abdominopelvic computerized tomography (CT) scan showed multiloculated cystic mass (120 ×100 ×80 mm) in lower portion of left kidney with internal enhancing solid components and coarse peripheral calcifications. Radical nephrectomy of left kidney was done and biopsy confirmed renal cell carcinoma (RCC), papillary type, sarcomatoid foci, Fuhrman grade III. We assumed that, presence of nephrotic syndrome and paraneoplastic glomerulopathy leaded to heavy proteinuria in this case. Secondary, paraneoplastic glomerulopathy such as immunoglobulin A nephropathy and focal segmental glomerulosclerosis as a paraneoplastic syndrome of RCC have been reported previously. RCC can present with a wide range of signs and symptoms. Atypical presentations of papillary RCC such as proteinuria should be considered for patients presenting with nephrotic syndrome.

IL-6-producing Renal Cell Carcinoma Causing Renal and Endocrine Paraneoplastic Syndromes

“…In fact, RCC is often diagnosed as an incidental finding during abdominal ultrasound or CT that is performed for an unrelated reason (29) or via the identification of a paraneoplastic syndrome (29,30). The results of the present study as well as a previous study that also reported the coexistence of RCC and severe proteinuria (31) suggest that systemic changes in CKD patients may be signs of tumors or paraneoplastic syndromes. However, future cohort studies are needed to further evaluate this association.…”

Long Non-Coding RNAs as Novel Biomarkers in the Clinical Management of Papillary Renal Cell Carcinoma Patients: A Promise or a Pledge?

“…Paraneoplastic manifestations, with constitutional signs and symptoms (fever, cachexia, and weight loss), hypertension and/or metabolic anomalies (hypercalcemia, polycythemia, amyloidosis, hepatic dysfunction, and Cushing's syndrome) can also be present as in other RCCs [76]. For instance, new-onset proteinuria and various neuropathies have been documented specifically in pRCC cases [80][81][82][83].…”