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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