From the Guidelines
Paraneoplastic syndromes associated with Renal Cell Carcinoma (RCC) include hypercalcaemia, fever, and erythrocytosis, which are usually reversed after tumour resection. These symptoms are caused by hormones or cytokines excreted by tumour cells or by an immune response against the tumour 1. The exact prevalence of these syndromes is not specified in the provided evidence, but it is mentioned that they are not uncommon in RCC.
Key Paraneoplastic Syndromes
- Hypercalcaemia: caused by hormones or cytokines excreted by tumour cells
- Fever: caused by an immune response against the tumour
- Erythrocytosis: caused by hormones or cytokines excreted by tumour cells It is essential to note that these symptoms can be variable and may not be present in all patients with RCC. However, when they do occur, they can often be managed by treating the underlying tumour through surgical resection, which can lead to the reversal of these symptoms 1.
Management of Paraneoplastic Syndromes
- Treatment of the underlying RCC through surgical resection
- Symptomatic management of hypercalcaemia, fever, and erythrocytosis as needed The provided evidence does not specify the exact management strategies for these paraneoplastic syndromes, but it is generally accepted that treating the underlying tumour is the most effective way to manage these symptoms 1.
From the Research
Paraneoplastic Syndromes Associated with Renal Cell Carcinoma (RCC)
The paraneoplastic syndromes associated with RCC include:
- Hypercalcemia 2, 3, 4, 5
- Cachexia 2, 3
- Fever 2, 3
- Hepatic dysfunction 2, 3
- Anemia 2
- Amyloidosis 2, 3
- Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 5
- Tumor lysis syndrome 5
- Renin-producing tumors 5
- Paraneoplastic glomerulopathies 5
Clinical Presentation and Diagnosis
Paraneoplastic syndromes can be the initial clinical presentation of RCC in a significant number of patients 2, 3, 4. Recognition of these syndromes may facilitate early diagnosis. The presence of a paraneoplastic syndrome in a patient with RCC is neither a marker of metastatic disease nor necessarily indicative of a poor prognosis 3.
Treatment and Management
Most paraneoplastic syndromes associated with RCC remit after resection of the primary RCC or treatment of metastatic sites 2. Nephron-sparing surgery may also play a role in the management of paraneoplastic symptoms associated with hereditary RCC 6. Conventional medical therapies are seldom helpful, except for hypercalcemia 2.