{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T01:13:56Z","timestamp":1783646036074,"version":"3.55.0"},"reference-count":12,"publisher":"Aerospace Medical Association","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    <jats:bold>BACKGROUND:<\/jats:bold>\n                    Renal cell carcinoma (RCC) is a relatively uncommon medical illness among the civilian population and less common within the U.S. Air Force pilot population. While the classic presentation of RCC is macroscopic hematuria, flank pain, and palpable flank mass, these are rarely seen. RCC is often clinically silent and it is not uncommon for RCC to be incidentally discovered in an already highly metastasized state.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CASE REPORT:<\/jats:bold>\n                    A 44-yr-old male fifth-generation fighter pilot presented with acute chronic lower back pain who was evaluated with routine x-rays, which led to the incidental discovery of RCC. The patient underwent left nephrectomy for a potential cure. He was initially diagnosed with Stage II RCC but was later found to have metastatic disease to the lungs. The patient subsequently underwent immunotherapy and was able to finish his military career in a nonflying status prior to his death approximately 7 yr after his initial diagnosis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>DISCUSSION:<\/jats:bold>\n                    Our patient was treated with the classic surgical approach, but at the time of surgery, the tumor had already spread to the vasculature and metastasized. The late-stage RCC at diagnosis necessitated a nonflying status for the remainder of his military career. Training costs of a fifth-generation fighter pilot as of 2018 reached upwards of $10.9 million. The pilot described had significant military training and flying experience, which likely incurred an estimated $30 million in loss. This case highlights the need for close monitoring and proactive screening of this special patient population.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      Woodside S, Nguyen D, Smith J, Udy A, Whetsone T, Zhang J.\n                      <jats:italic>Incidental renal cell carcinoma in an active-duty fighter pilot<\/jats:italic>\n                      . Aerosp Med Hum Perform. 2026; 97(7):539\u2013542.\n                    <\/jats:bold>\n                  <\/jats:p>","DOI":"10.3357\/amhp.6311.2026","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:30:29Z","timestamp":1783643429000},"page":"539-542","source":"Crossref","is-referenced-by-count":0,"title":["Incidental Renal Cell Carcinoma in an Active-Duty Fighter Pilot"],"prefix":"10.3357","volume":"97","author":[{"given":"Sarah","family":"Woodside","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin","family":"Udy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Whetstone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1911","reference":[{"key":"B1","article-title":"SEER Cancer Stat Facts: Kidney and Renal Pelvis Cancer","unstructured":"SEER Cancer Stat Facts: Kidney and Renal Pelvis Cancer. Bethesda (MD): National Cancer Institute. [Accessed 5\/8\/2026]. Available from: https:\/\/seer.cancer.gov\/statfacts\/html\/kidrp.html."},{"issue":"4","key":"B2","series-title":"Nihon Jinzo Gakkai Shi.","first-page":"409","article-title":"[Clinical study of renal cell carcinoma as incidental finding]","volume":"33","author":"Yazaki T","year":"1991","unstructured":"Yazaki T, Iiyama T, Sato S, Hata R, Amemiya H,  [Clinical study of renal cell carcinoma as incidental finding]. Nihon Jinzo Gakkai Shi. 1991 Apr; 33(4):409\u201315. Japanese."},{"issue":"3","key":"B3","series-title":"Am Fam Physician.","first-page":"179","article-title":"Renal cell carcinoma: diagnosis and management","volume":"99","author":"Gray RE","year":"2019","unstructured":"Gray RE, Harris GT. Renal cell carcinoma: diagnosis and management. Am Fam Physician. 2019 Feb 1; 99(3):179\u201384. 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Wright-Patterson AFB (Ohio): US Air Force; 2025."},{"issue":"2","key":"B8","series-title":"Eur Urol Focus.","first-page":"407","article-title":"A decision analysis evaluating screening for kidney cancer using focused renal ultrasound","volume":"7","author":"Rossi SH","year":"2021","unstructured":"Rossi SH, Klatte T, Usher-Smith JA, Fife K, Welsh SJ,  A decision analysis evaluating screening for kidney cancer using focused renal ultrasound. Eur Urol Focus. 2021 Mar; 7(2):407\u201319."},{"issue":"4","key":"B9","series-title":"World J Urol.","first-page":"929","article-title":"Screening programs for renal cell carcinoma: a systematic review by the EAU young academic urologists renal cancer working group","volume":"41","author":"Diana P","year":"2023","unstructured":"Diana P, Klatte T, Amparore D, Bertolo R, Carbonara U,  Screening programs for renal cell carcinoma: a systematic review by the EAU young academic urologists renal cancer working group. World J Urol. 2023 Apr; 41(4):929\u201340."},{"issue":"7","key":"B10","series-title":"Nat Med.","first-page":"1041","article-title":"Detection of renal cell carcinoma using plasma and urine cell-free DNA methylomes","volume":"26","author":"Nuzzo PV","year":"2020","unstructured":"Nuzzo PV, Berchuck JE, Korthauer K, Spisak S, Nassar AH,  Detection of renal cell carcinoma using plasma and urine cell-free DNA methylomes. Nat Med. 2020 Jul; 26(7):1041\u20133. Erratum in: Nat Med. 2020 Oct; 26(10):1663."},{"issue":"6","key":"B11","series-title":"JAMA Intern Med.","first-page":"800","article-title":"Cost-effectiveness of common diagnostic approaches for evaluation of asymptomatic microscopic hematuria","volume":"177","author":"Halpern JA","year":"2017","unstructured":"Halpern JA, Chughtai B, Ghomrawi H. Cost-effectiveness of common diagnostic approaches for evaluation of asymptomatic microscopic hematuria. 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