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Spurious polycythemia and renal malignancy
Southern Medical Journal
|August 1, 1987
Summary
A young woman with polycythemia was diagnosed with spurious polycythemia due to dehydration. A kidney neoplasm was discovered and removed, resolving the polycythemia.
Area of Science:
- Nephrology
- Oncology
- Hematology
Background:
- Polycythemia, characterized by elevated hemoglobin or hematocrit, can be primary or secondary.
- Spurious polycythemia, or relative polycythemia, results from decreased plasma volume rather than increased red cell mass.
Observation:
- A 19-year-old woman presented with polycythemia, initially suspected to be primary.
- Diagnostic evaluation revealed normal red cell mass with decreased plasma volume, indicating spurious polycythemia.
- Abdominal CT scan identified a 4 cm mass in the right kidney.
Findings:
- The renal mass was surgically removed (right nephrectomy).
- Histopathological examination revealed an unusual neoplasm of the renal tubular epithelium.
- Post-nephrectomy, the patient's hemoglobin and hematocrit levels normalized within four weeks.
Implications:
- This case highlights the importance of differentiating spurious polycythemia from true polycythemia.
- Renal neoplasms can present with paraneoplastic syndromes, including polycythemia.
- Nephrectomy effectively treated the polycythemia in this patient, suggesting a link to the renal tumor.