Renal cell carcinoma which is among genitourinary cancers is a pathology presenting with signs and symptoms of paraneoplastic syndrome in almost one third of the affected patients. The paraneoplastic syndromes associated with renal cell carcinoma include constitutional symptoms (ie, fever, cachexia, and weight loss), as well as specific metabolic and biochemical abnormalities (ie, hypercalcemia, nonmetastatic hepatic dysfunction, amyloidosis, etc). The presence of a paraneoplastic syndrome in a patient with renal cell carcinoma is neither a marker of metastatic disease nor necessarily indicative of a poor prognosis. The importance of understanding the pathophysiology and biology behind the many paraneoplastic syndromes associated with renal cell carcinoma lies in the fact that the presence of these protean symptoms may be the initial presentation of either primary or recurrent disease. In these patients, the accurate diagnosis and management of paraneoplastic syndromes may be important in palliative management. Pathophysiology of paraneoplastic symptoms of RCC such as cachexia, fever, hepatic dysfunction, anemia, and amyloidosis, remains incomplete. Except for hypercalcemia, conventional medical therapies are seldom helpful in the treatment of paraneoplastic symptoms. An early diagnosis and effective treatment might improve quality of life and alter prognosis of these patients. In this review, we will describe the proposed mechanisms of action of the many paraneoplastic syndromes associated with RCC as well as outline the clinical evaluation and treatment options currently available for these noteworthy disorders. (Bulletin of Urooncology 2014;13:130-134)

Keywords: Paraneoplastic syndrome, renal cell carcinoma, hypercalcemia