A 69-year-old woman presents to the emergency department with symptoms of left flank pain and hematuria. On physical examination, the blood pressure is 165/96 mmHg, heart rate is 104/min, and the abdomen is soft and nontender. There is some left costo-vertebral angle tenderness on percussion. A computerized tomography (CT) scan of the abdomen reveals a 5-cm mass in the left kidney. (See Figure below) Which of the following laboratory abnormalities might also be present?
Correct Answer: polycythemia
Description: This patient likely has renal cell carcinoma (RCC). Polycythemia is caused by the production of erythropoietin-like factors. There is no relationship to hypertension. The tumor frequently presents as metastatic disease. Thrombocytopenia is not a feature of RCC, and hypercalcemia may occur if there is bone metastasis. High renin production does not occur in RCC either.
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