- "Classic triad": flank pain, a palpable mass, and hematuria is now seen in less than 10% of patients.
- Hematuria (gross or microscopic) seen most often among the classic symptoms
- Increasing number of lesions (>25%) are seen as incidental findings on imaging for other conditions
- Systemic syndromes
- Anemia, fatigue, cachexia, weight loss 20-40%
- Hypercalcemia 10-15 %
- Hepatic dysfunction (Stauffer's syndrome) 5%
- Rare syndromes: Erthrocytosis, protein wasting enteropathy, neuomyopathy, amyloidosis
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