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Published 7 April 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.06.2008.0007]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Unusual association of diseases/symptoms

Difficulties diagnosing psychiatric paraneoplastic syndromes in patients with a psychiatric history: a patient with secondary mania and renal cell carcinoma

Romina Lopez Gaston, Lenia Constantine

Worcester Mental Health Partnership Trust, Adult Psychiatry, Touchstone Centre, 41 Geraldine Road, Worcester, Worcestershire WR14 3NT, UK

Correspondence to:
Romina Lopez Gaston, logaston1{at}hotmail.com

SUMMARY

Renal cell carcinoma (RCC) is characterised by lack of early warning signs. The classic triad (palpable mass, haematuria and flank pain) occurs in less than 15% of cases and paraneoplastic syndromes develop in 10–40%, often preceding the detection of the neoplasm. This report describes a 51-year-old woman who displayed manic symptomatology and was investigated due to anaemia. RCC was diagnosed and her psychiatric symptomatology remitted after the nephrectomy.


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