Clinically silent renal tumour producing erythropoietin

Abstract

Asymptomatic patients may be referred for a haematology opinion when the routine blood count reveals elevation in haemoglobin level, haematocrit or red cell count.1 There is an all too cavalier approach to this abnormality, which is not only an independent risk factor for arterial or venous thromboembolic disease2 but may signal unsuspected underlying cardiac or pulmonary pathology.3 Infrequently these findings may draw attention to an otherwise silent myeloproliferative syndrome in the form of primary proliferative polycythaemia or polycythaemia rubra vera of old.4 Occasionally, and of major clinical importance, is inappropriate erythropoietin production by tumours, including kidney tumours.