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Updated: Jan 25, 2026
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Published on: November 10, 2023
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Renal Cell Carcinoma Presenting as Pleural Effusion
Abeer Arain1, Mahesh Swaminathan2, James Kumar2
1Department of Internal Medicine, University of Illinois Urbana-Champaign; Champaign,Illinois, aarain@illinois.edu.
Summary
This case study highlights a rare instance of renal cell carcinoma (kidney cancer) presenting as a pleural effusion (fluid around the lungs). This unusual presentation underscores the importance of considering uncommon diagnoses in medical practice.
Area of Science:
- Oncology
- Pulmonology
- Nephrology
Background:
- Renal cell carcinoma (RCC) is known for diverse clinical presentations.
- Malignant pleural effusion (MPE) is typically associated with lung or breast cancers.
- RCC presenting as MPE is exceptionally rare, accounting for only 1-2% of MPE cases.
Observation:
- A 34-year-old male presented with dyspnea.
- Imaging revealed a right-sided pleural effusion and a suspicious left kidney mass.
- CT-guided pleural fluid analysis showed specific markers.
Findings:
- Cytology results were positive for vimentin and CD10.
- Diagnosis confirmed as primary renal cell carcinoma.
- The presentation was unilateral pleural effusion without apparent lung metastasis.
Implications:
- This case emphasizes the importance of considering extrathoracic malignancies, such as RCC, in the differential diagnosis of unexplained pleural effusions.
- Highlights the diagnostic challenge of RCC metastasis presenting solely as pleural effusion.
- Suggests the need for thorough investigation of the renal tract in cases of MPE with atypical immunophenotypes.
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