Renal cell cancer (RCC)

is also known as

hypernephroma

and accounts for 85% of primary renal neoplasms. It arises from proximal renal tubular epithelium

Associations*

• more common in middle-aged men
• smoking
• von Hippel-Lindau syndrome
• tuberous sclerosis

Features

• classical triad: haematuria, loin pain, abdominal mass
• pyrexia of unknown origin
• left varicocele (due to occlusion of left testicular vein)
• endocrine effects: may secrete erythropoietin (polycythaemia), parathyroid hormone (hypercalcaemia), renin, ACTH
• 25% have metastases at presentation

Scenario:

Patient with history and features of STI with orchitis having varicocele to left scrotum;

Q: the most important Dx to rule out?

Management