Work

Atypical presentation of renal cell carcinoma with lactic acidosis: case report and literature review

Year: 2025

Type: article

Abstract: Renal cell carcinoma is often difficult to diagnose early due to its nonspecific clinical presentation, which extends beyond the classic triad of flank pain, hematuria, and a flank mass. Recognizing alternative indicators, such as microscopic hematuria and lactic acidosis, can aid in early detection. A 77-year-old male with diabetes, varicose veins, and tobacco use presented with weakness, nausea, dyspnea, and poor appetite. He exhibited somnolence, confusion, transaminitis, elevated alkaline phosphatase, and severe lactic acidosis. Urinalysis revealed microscopic hematuria. Imaging showed bilateral pleural effusions and a right hepatic lesion. A computed tomography scan identified a large renal mass invading the renal vein, inferior vena cava, and right atrium. The patient developed deep vein thromboses and underwent radical nephrectomy, but succumbed postoperatively. This case highlights renal cell carcinoma's potential for atypical presentations, emphasizing the importance of early recognition and comprehensive diagnostic approaches to improve outcomes.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf290

Authors: Henry Alocha, Islam Rajab, Noman Khalid, Ibraheem Sabah, Abdelfattah M Dahmas, Rawda Mahajna

Institutions: St. Joseph’s University Medical Center, An-Najah National University

Language: English

Topic: Renal cell carcinoma treatment

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000