A 53-year-old man has had constant dull pain in his lower right back for the past 4 months. On physical examination there is tenderness on percussion of his right costovertebral angle. An abdominal CT scan reveals a 6 cm mass in the upper pole of the right kidney. A CBC shows: Hgb 21.3 g/dL, Hct 64.0%, MCV 96 fL, platelet count 199,000/microliter, and WBC count 8230/microliter. Serum chemistries include glucose 77 mg/dL, urea nitrogen 17 mg/dL, and creatinine 1.1 mg/dL. Which of the following is the most likely cause for his findings? A Polycythemia rubra vera B Erythroleukemia C Hemophilia A D Diabetes insipidus E Increased erythropoietin

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E. Patient has RCC, with erythropoietin secretion

that's correct

Answer E. He has polycythemia. Paraneoplastic manifestation of RCC due to increased EPO secretion.

E rcc with erythropoeitin secretion

E. increased erythropoietin

Answer is E. Possibly due to RCC, Pt developed Paraneoplastic Polycythemia. its due to increased EPO secretion.

Increased erythropoietin

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