Case Ico-delete Highlights A 65-year-old man presents with flank pain, blood in his urine, and an unexplained weight loss. His past medical history is significant for numerous infections, kidney stones, cigarette use, and alcohol use. On physical exam, there is a palpable abdominal mass, as well as a low-grade fever. Diagnostic tests determine that he has cancer. Question What puts this patient at risk for the development of his particular type of cancer? {Ans: Correct answer: Smoking Explanation This patient has renal cell carcinoma. Smoking is a risk factor for many neoplasms, including renal cell carcinoma. There is a classic triad associated with renal cell carcinoma: hematuria, flank pain, and a palpable abdominal mass. The classic triad is not seen in most patients, however. Other presenting symptoms include a fever and weight loss. Cells from the proximal convoluted tubule are the most common cells from which renal carcinoma arises. There is an increased incidence of renal cell carcinoma with von Hippel-Lindau disease. Escherichia coli infection, urolithiasis, and interstitial nephritis are not known risk factors. Schistosoma haematobium infection is associated with bladder tumors, not renal cell carcinoma.}Case Ico-delete Highlights An 18-year-old pregnant woman presents with polyuria and increased urinary frequency.