Rapidly relapsing squamous cell carcinoma of the renal pelvis associated with paraneoplastic syndromes of leukocytosis, thrombocytosis and hypercalcemia

A case history is reported here in which leukocytosis, thrombocytosis and h ypercalcemia associated with rapidly relapsing squamous cell carcinoma (SCC ) of the renal pelvis were observed. In a 58-year-old man, SCC of the renal pelvis was documented during nephrolithotomy, and right nephrectomy was pe rformed. Local relapse of the tumor occurred rapidly in 2 months' time and hypercalcemia, leukocytosis and thrombocytosis worsened in accordance with tumor volume. Cranial computerized tomography (CT), thorax CT and bone scin tigraphy were negative for metastasis. The serum parathyroid hormone level was 28 pg/ml (normal 9-55 pg/ml). To disclose leukocytosis and thrombocytos is, peripheral smear and bone marrow aspiration were performed and no patho logic finding regarding any hematologic disorder was found; the samples wer e also BCR-ABL negative and Philadelphia chromosome negative. Production of several factors by tumor cells may be responsible for this paraneoplastic syndrome. The association of SCC of the renal pelvis with this triple paran eoplastic syndrome is an extremely rare occurrence. Copyright (C) 2001 S. K arger AG, Basel.