title: Renal cell carcinoma with  skull base metastasis preceded by paraneoplastic signs in a chronic hemodialysis patient.
abstract: A 59-year-old man who had received chronic hemodialysis developed left occipital pain and hypoglossal nerve palsy. He was diagnosed as having skull base metastasis from renal cell carcinoma related to acquired cystic kidney. Retrospective analysis revealed the patient had had elevated serum C-reactive protein and alkaline phosphatase levels before the symptoms appeared. Radiotherapy to the skull base relieved the pain. Finally he died with generalized 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.
authors.affiliation: Department of General Medicine, Omiya Medical Center, Jichi Medical School, Saitama.
authors.forename: K
authors.initials: K
authors.lastname: Endo
authors.forename: R
authors.initials: R
authors.lastname: Okano
authors.forename: Y
authors.initials: Y
authors.lastname: Kuroda
authors.forename: S
authors.initials: S
authors.lastname: Yamada
authors.forename: K
authors.initials: K
authors.lastname: Tabei
mesh_terms: D002292:Carcinoma, Renal Cell / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D002908:Chronic Disease; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000628:therapy; D007680:Kidney Neoplasms / Q000097:blood / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes; D006435:Renal Dialysis; D019292:Skull Base Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D014057:Tomography, X-Ray Computed