Multisystem Crisis in a Patient with Presumptive Renal Cell Carcinoma

Abstract We describe the case of a patient who presented with a kidney lesion, lymphadenopathy, and bone metastasis. He developed a tetrad of high fever, encephalopathy, labile blood pressure, and multiple organ system failure. Initially, he was diagnosed with metastatic renal cell carcinoma (RCC)....

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Bibliographic Details
Published in:Clinical genitourinary cancer 2008-09, Vol.6 (2), p.128-130
Main Authors: Bilen, Mehmet A, Waguespack, Steven G, Tannir, Nizar M, Pravinkumar, S. Egbert, Tamboli, Pheroze, Tu, Shi-Ming
Format: Article
Language:English
Subjects:
Adrenal Gland Neoplasms - diagnosis
Aged
Bone metastasis
Bone Neoplasms - secondary
Brain Diseases - complications
Carcinoma, Renal Cell - pathology
Encephalopathy
Fever
Fever - complications
Hematology, Oncology and Palliative Medicine
Humans
Kidney Neoplasms - pathology
Lymphadenopathy
Male
Multi-organ failure
Multiple Organ Failure - etiology
Pheochromocytoma
Pheochromocytoma - diagnosis
Urology
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Summary:Abstract We describe the case of a patient who presented with a kidney lesion, lymphadenopathy, and bone metastasis. He developed a tetrad of high fever, encephalopathy, labile blood pressure, and multiple organ system failure. Initially, he was diagnosed with metastatic renal cell carcinoma (RCC). His fevers and encephalopathy were compatible with a putative paraneoplastic syndrome. Eventually, he was found to have malignant pheochromocytoma. To our knowledge, this is the first reported case of a malignant pheochromocytoma with multisystem crisis. Because of its atypical presentation and unusual findings, a high index of suspicion is necessary for the timely diagnosis of this clinical entity. Prompt diagnosis and appropriate treatments could improve the performance status and quality of life of such patients.
ISSN:1558-7673
1938-0682
DOI:10.3816/CGC.2008.n.021