{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:32:54Z","timestamp":1753878774801,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Renal cell carcinoma is often difficult to diagnose early due to its nonspecific clinical presentation, which extends beyond the classic triad of flank pain, hematuria, and a flank mass. Recognizing alternative indicators, such as microscopic hematuria and lactic acidosis, can aid in early detection. A 77-year-old male with diabetes, varicose veins, and tobacco use presented with weakness, nausea, dyspnea, and poor appetite. He exhibited somnolence, confusion, transaminitis, elevated alkaline phosphatase, and severe lactic acidosis. Urinalysis revealed microscopic hematuria. Imaging showed bilateral pleural effusions and a right hepatic lesion. A computed tomography scan identified a large renal mass invading the renal vein, inferior vena cava, and right atrium. The patient developed deep vein thromboses and underwent radical nephrectomy, but succumbed postoperatively. This case highlights renal cell carcinoma\u2019s potential for atypical presentations, emphasizing the importance of early recognition and comprehensive diagnostic approaches to improve outcomes.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf290","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T20:53:54Z","timestamp":1746478434000},"source":"Crossref","is-referenced-by-count":0,"title":["Atypical presentation of renal cell carcinoma with lactic acidosis: case report and literature review"],"prefix":"10.1093","volume":"2025","author":[{"given":"Henry","family":"Alocha","sequence":"first","affiliation":[{"name":"Department of Internal Medicine , St. Joseph\u2019s University Medical Center, 703 Main Street, Paterson, Passaic County, NJ 07503,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Islam","family":"Rajab","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , St. Joseph\u2019s University Medical Center, 703 Main Street, Paterson, Passaic County, NJ 07503,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noman","family":"Khalid","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , St. Joseph\u2019s University Medical Center, 703 Main Street, Paterson, Passaic County, NJ 07503,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibraheem","family":"Sabah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , St. Joseph\u2019s University Medical Center, 703 Main Street, Paterson, Passaic County, NJ 07503,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelfattah M","family":"Dahmas","sequence":"additional","affiliation":[{"name":"Department of Medicine , Faculty of Medicine and Health Sciences, An-Najah National University, Nablus Street, New Campus, Nablus, West Bank 00970,","place":["Palestine"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rawda","family":"Mahajna","sequence":"additional","affiliation":[{"name":"Department of Medicine , Faculty of Medicine and Health Sciences, An-Najah National University, Nablus Street, New Campus, Nablus, West Bank 00970,","place":["Palestine"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,5]]},"reference":[{"key":"2025050516534474300_ref1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/nrdp.2017.9","article-title":"Renal cell carcinoma","volume":"3","author":"Hsieh","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"2025050516534474300_ref2","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1093\/aje\/kwm170","article-title":"Risk factors for renal cell cancer: the multiethnic cohort","volume":"166","author":"Setiawan","year":"2007","journal-title":"Am J Epidemiol"},{"key":"2025050516534474300_ref3","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.ucl.2004.01.004","article-title":"Risk factors for adult renal cell carcinoma","volume":"31","author":"Dhote","year":"2004","journal-title":"Urol Clin"},{"key":"2025050516534474300_ref4","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1038\/nrurol.2010.46","article-title":"Epidemiology and risk factors for kidney cancer","volume":"7","author":"Chow","year":"2010","journal-title":"Nat Rev Urol"},{"volume":"16","author":"","key":"2025050516534474300_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)67916-5"},{"key":"2025050516534474300_ref6","first-page":"120","article-title":"Type B lactic acidosis in solid malignancies","volume":"69","author":"Groot","year":"2011","journal-title":"Neth J Med"},{"key":"2025050516534474300_ref7","doi-asserted-by":"publisher","first-page":"83","DOI":"10.3233\/KCA-160004","article-title":"A case report of severe type B lactic acidosis following first dose of nivolumab in a VHL-mutated metastatic renal cell carcinoma","volume":"1","author":"Nakajima","year":"2017","journal-title":"Kidney Cancer"},{"key":"2025050516534474300_ref8","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.tibs.2015.12.001","article-title":"The Warburg effect: how does it benefit cancer cells?","volume":"41","author":"Liberti","year":"2016","journal-title":"Trends Biochem Sci"},{"key":"2025050516534474300_ref9","doi-asserted-by":"publisher","first-page":"e3944","DOI":"10.7759\/cureus.3944","article-title":"A challenging case of coexisting type A and type B lactic acidosis: a case report","volume":"11","author":"Singh","year":"2019","journal-title":"Cureus"},{"key":"2025050516534474300_ref10","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1089\/end.2013.0724","article-title":"Current patterns of presentation and treatment of renal masses: a clinical research office of the endourological society prospective study","volume":"28","author":"Laguna","year":"2014","journal-title":"J Endourol"},{"key":"2025050516534474300_ref11","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s11934-021-01036-y","article-title":"Current trends in management of renal cell carcinoma with venous thrombus extension","volume":"22","author":"Jurado","year":"2021","journal-title":"Curr Urol Rep"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2025\/5\/rjaf290\/63056253\/rjaf290.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2025\/5\/rjaf290\/63056253\/rjaf290.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T20:53:54Z","timestamp":1746478434000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjaf290\/8125215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,29]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,4,29]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjaf290","relation":{},"ISSN":["2042-8812"],"issn-type":[{"type":"electronic","value":"2042-8812"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,4,29]]},"article-number":"rjaf290"}}