Paraneoplastic syndromes

Question 1

How common is paraneoplastic syndrome in patients with RCC?

Answer 1

1/3 patients

May indicate advanced disease

Question 2

What is the most common paraneoplastic syndrome?

Answer 2

hypercalcemia from parathyroid hormone related peptide (PTHrP) and PTH in the absence of bone metastasis

Question 3

Treatment of hypercalcemia paraneoplastic syndrome?

Answer 3

Loop diuretic (“loops lose calcium”)

Bisphosphonates

Treat the cancer (nephrectomy)

Question 4

What is Stauffer syndrome?

Answer 4

hepatic dysfunction in patients with NON-metastatic RCC

- majority resolve after primary tumor resection

Question 5

Polycythemia in RCC is due to what?

Answer 5

elevated erythropoietin

Question 6

Anemia in RCC is due to what?

Answer 6

elevated lactoferrin (binds iron) and poor nutrition/chronic disease

Question 7

What is more common, anemia or polycythemia, in RCC?

Answer 7

Anemia

Question 8

Hypertension in RCC is due to what?

Answer 8

elevated renin

- most common in low grade clear cell RCC

Question 9

What are some of the constitutional symptoms seen in RCC?

Answer 9

fevers, chills, night sweats, weight loss, fatigue