Severe hypercalcemia as the initial presentation of renal cell carcinoma
Annals of Medicine and Surgery,
Год журнала:
2025,
Номер
87(5), С. 3016 - 3022
Опубликована: Апрель 3, 2025
Introduction
and
importance:
Renal
cell
carcinoma
(RCC)
represents
90%
of
renal
malignancies
with
rising
global
incidence.
While
the
classic
triad
includes
hematuria,
flank
pain,
palpable
masses,
paraneoplastic
hypercalcemia
occurs
in
17%
cases
indicates
aggressive
disease
behavior.
This
case
documents
severe
as
initial
manifestation
metastatic
RCC.
Case
presentation:
A
64-year-old
male
presented
malaise,
bloating,
weight
loss.
Laboratory
evaluation
revealed
(15.1
mg/dL),
suppressed
parathyroid
hormone
(4.2
pg/mL),
elevated
hormone-related
peptide
(83
pg/mL).
Imaging
identified
a
5.5
×
5.0
5.3
cm
left
mass
metastases
to
lungs,
brain,
possibly
bone.
Biopsy
confirmed
clear-cell
Management
comprised
hydration,
zoledronic
acid,
combined
immunotherapy
(pembrolizumab/lenvatinib),
palliative
radiation
for
cerebral
lesions.
Clinical
discussion:
illustrates
PTHrP-mediated
humoral
malignancy
The
pathophysiology
differs
from
alternative
mechanisms
such
calcitriol-mediated
or
cytokine-driven
osteoclast
activation.
Diagnostic
markers
demonstrated
pattern
PTHrP
elevation
pg/mL)
PTH
suppression
multimodal
imaging
protocol
effectively
delineated
primary
tumor
dimensions,
vascular
invasion,
burden.
Treatment
efficacy
was
objectively
measured
through
serial
calcium
levels
documented
radiographic
regression
aligns
recent
data
on
combination
(anti-PD-1)
tyrosine
kinase
inhibition
advanced
RCC,
supporting
current
therapeutic
paradigms
disease.
Conclusion:
Prompt
recognition
RCC
facilitates
timely
intervention.
demonstrates
value
comprehensive
diagnostic
multidisciplinary
management
combining
supportive
care
targeted
immunotherapy.
Further
prospective
studies
are
needed
optimize
strategies
patients
presenting
metabolic
derangements
suggestive
underlying
malignancy.
Язык: Английский
Role of 18F-FDG-PET in renal tumors: insights from WHO 2022 classification
Japanese Journal of Radiology,
Год журнала:
2025,
Номер
unknown
Опубликована: Апрель 7, 2025
Abstract
The
objective
of
this
article
is
to
provide
a
comprehensive
overview
the
imaging
characteristics
various
renal
cell
tumors
using
18F-fluorodeoxyglucose
(FDG)-positron
emission
tomography
(PET),
based
on
latest
WHO-2022
classification.
Due
physiological
accumulation
FDG
in
kidneys,
clinical
utility
FDG-PET
evaluation
has
traditionally
been
considered
limited.
However,
recent
studies
have
re-evaluated
its
potential
value.
demonstrated
particular
detecting
metastases
and
postoperative
recurrence
carcinoma
(RCC),
as
well
identifying
RCC
patients
with
chronic
kidney
failure,
where
excretion
into
urinary
tract
reduced.
Renal
are
occasionally
detected
incidentally
FDG-PET,
uptake
varies
depending
tumor
subtype.
Therefore,
understanding
these
clinically
important,
it
may
serve
valuable
guide
for
subsequent
diagnostic
evaluations.
Furthermore,
advancements
development
novel
PET
tracers
hold
promise
future
applications
tumors.
We
believe
that
insights
gained
from
study
will
contribute
routine
practice
planning
research.
Язык: Английский