Cough as Presenting Symptom of Renal Cell Carcinoma

• Published in: SN comprehensive clinical medicine Vol. 3; no. 1; pp. 221 - 226
• Main Authors: Giffen, Zane C., Flynn, Ryan M., Mostafa, Hesham I., Schuster, George A., Weizer, Alon Z., Redman, Bruce G., Roberts, William W., Schuster, Timothy G.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 2021
• Subjects: Medicine; Medicine & Public Health; Surgery; Topical Collection on Surgery; Paraneoplastic syndrome; Renal mass; Renal cell carcinoma; Cough
• ISSN: 2523-8973; 2523-8973
• DOI: 10.1007/s42399-020-00666-6

Renal cell carcinoma (RCC) presenting with cough is a rare phenomenon, which is likely an immune-mediated paraneoplastic syndrome. To our knowledge, there are a few individual case reports and one case series in the literature. We report our experience with chronic cough as the presenting symptom for RCC. A retrospective chart review was performed on cases presenting with RCC and cough at two institutions. A recent case at a third institution was also included. The literature was reviewed via an Ovid MEDLINE search to reveal fourteen previously reported cases. Eight new cases were identified of patients presenting with a cough and subsequently being diagnosed with RCC. All cases of RCC were identified incidentally due to imaging obtained during a workup for chronic cough. Average age at presentation was 66.5 years old (range 54–79). Renal tumor size ranged from 3.8 to 10 cm. Final pathology was clear cell renal cell carcinoma in all patients, with one patient having Xp11 translocation. Six of the patients had resolution of the cough after resection of the primary tumor despite one patient with metastatic disease. One other patient reported a significant improvement. The final patient had transient improvement in her cough after cytoreductive nephrectomy. Chronic cough is a rare presentation of RCC. Treatment of the primary tumor with resection or embolization may lead to resolution of the cough, even in some patients with metastatic disease.