Uncontrolled Hypertension Leading to the Diagnosis of Renal Cell Carcinoma: A Case Report

Renal cell carcinoma (RCC) is frequently diagnosed unexpectedly, as early disease usually lacks clinical findings. Although hypertension is a risk factor for RCC, it may also represent a paraneoplastic manifestation of the disease. We report the case of a man who presented to the emergency department with acute ear pain and was found to have severe, newly diagnosed hypertension. Despite multidrug antihypertensive therapy, blood pressure remained poorly controlled, prompting further investigation for secondary causes. Imaging studies revealed a cystic renal mass, and the patient underwent partial nephrectomy, with histopathological confirmation of RCC. After tumor resection, the patient maintained improved blood pressure control over time, allowing a reduction of his antihypertensive therapy. This case highlights resistant hypertension as a potential manifestation of an underlying malignancy and underscores the importance of a comprehensive clinical approach in patients with poorly controlled hypertension.