Renal cell carcinoma with skull base metastasis preceded by paraneoplasticsigns in a chronic hemodialysis patient

A 59-year-old man who had received chronic hemodialysis developed left occi pital pain and hypoglossal nerve palsy. He was diagnosed as having skull ba se metastasis from renal cell carcinoma related to acquired cystic kidney. Retrospective analysis revealed the patient had had elevated serum C-reacti ve protein and alkaline phosphatase levels before the symptoms appeared. Ra diotherapy to the skull base relieved the pain. Finally he died with genera lized metastases. Serum interleukin-6 levels measured during admission had been elevated, and interleukin-6 mRNA was detected in the autopsy specimen of renal cell carcinoma. Interleukin-6 might be involved in the etiology of paraneoplastic signs.