Editing Kidney Cancer: Diagnosis and Evaluation (section)

=== Paraneoplastic syndromes in RCC ===
* '''Found in 10-20% of patients with metastatic RCC (<span style="color:#0000ff">NEW-HALF-CAP</span>):'''
*# '''<span style="color:#0000ff">N</span><span style="color:#ff0000">europathy</span>''' (3%)
*# '''<span style="color:#0000ff">E</span><span style="color:#ff0000">levated ESR </span>(56%, most common)'''
*# '''<span style="color:#0000ff">W</span><span style="color:#ff0000">eight loss</span>''' (34%)
*# '''<span style="color:#0000ff">H</span><span style="color:#ff0000">ypertension</span>''' (38%)
*#* Can be due to elevated renin production by tumour, compression of renal artery, or AV fistula in tumour
*# '''<span style="color:#0000ff">A</span><span style="color:#ff0000">nemia</span>''' (36%)
*# '''<span style="color:#ff0000">Elevated </span><span style="color:#0000ff">L</span><span style="color:#ff0000">FTs''' (14%)
*#* Due to nonmetastatic hepatic dysfunction, also known as Stauffer syndrome
*# '''<span style="color:#0000ff">F</span><span style="color:#ff0000">ever</span>''' (17%)
*# '''<span style="color:#ff0000">Hyper</span><span style="color:#0000ff">C<span style="color:#ff0000">alcemia</span>''' (5%)
*#* Can be due to (2):
*#*# Paraneoplastic phenomena (production of PTH-related protein)
*#*# Osteolytic metastatic involvement of the bone
*#* '''Signs and symptoms include nausea, anorexia, fatigue, and decreased deep tendon reflexes'''
*#* '''Management includes vigorous hydration followed by diuresis with furosemide and the selective use of bisphosphonates (if adequate renal function),''' corticosteroids or calcitonin
*# '''<span style="color:#0000ff">A</span><span style="color:#ff0000">myloidosis</span>''' (2%)
*# '''<span style="color:#0000ff">P</span><span style="color:#ff0000">olycythemia</span>''' (4%)
* '''Management'''
** '''Treatment of paraneoplastic syndromes has required surgical excision or systemic therapy''' and, except for hypercalcemia, medical therapies have not proved helpful.