Rare Presentations of Renal Cell Carcinoma in Chronic Kidney Disease: A Retrospective Case Series

Chronic kidney disease (CKD) significantly increases the risk of malignancies, particularly renal cell carcinoma (RCC), which exhibits atypical clinical features and aggressive behaviour in this population. This retrospective case series explores the clinical profiles of four CKD patients diagnosed with RCC, each presenting with unique clinical manifestations and complications. Case 1 highlights metastatic papillary RCC in a patient on long-term hemodialysis who presented with with chest mass. Case 2: a young woman on continuous ambulatory peritoneal dialysis (PD) with hemorrhagic PD effluent was subsequently diagnosed with RCC and had rapid deterioration. Case 3 discusses a woman with RCC involving extensive venous thrombosis with intracardiac extension. Case 4 details a patient with clear cell RCC associated with diabetic kidney disease, who responded well to radical nephrectomy. The study underscores the diverse clinical presentations of RCC in CKD patients. Routine surveillance and heightened clinical suspicion are essential for the early diagnosis and improved outcomes.