Systemic effects of hypernephroma

In a study of 30 patients with hypernephromas, 23 patients manifested systemic effects of the tumor, and in 5 of these, the systemic effects were the presenting feature that led to the diagnosis. In contrast to this, only 17 patients had urologic complaints, and no single patient in this study had the classic triad of hematurial, loin pain, and mass. Weight loss (52 per cent), pyrexia, and elevated sedimentation rate (36 per cent) were seen most frequently. Anemia was seen in 25 per cent of patients. Other features seen in this group wer abnormalities in liver function, elevated alkaline phosphatase, hypertension, erythrocytosis, and hypercalcemia. In the majority of instances, removal of tumor was associated with remission of these effects. The effects were classified as those of a general toxic nature, those due to normal or abnormal production of hormones, and those due to production of abnormal substances by tumor cells. The evaluation of these effects was useful in making an early diagnosis and in follow-up care.