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Introduction <p>Both primary and secondary polycythemias can have erythropoietin (EPO) levels that overlap with the normal reference range. Generally, patients with secondary polycythemia have higher EPO concentrations than patients with polycythemia vera.</p> Case presentation <p>In clear cell renal cell carcinoma (ccRCC) increased EPO levels have been documented. However, we report the case of a 73-year-old man with polycythemia secondary to ccRCC, who presented with a normal serum EPO level.</p> Conclusion <p>ccRCC should always be considered in the differential diagnosis of polycythemia even with normal EPO levels. This case highlights that a normal EPO level does not exclude an underlying neoplasm. Imaging should be promptly considered as part of the diagnostic work-up.</p>

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Polycythemia and normal erythropoietin level: still clear cell renal cell carcinoma

  • 期刊论文

  • 发表日期：

    2025年8月15日

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  • Anne-Marie A. M. Mastenbroek,
  • Ward EJ Libourel,
  • Huib Ceelie,
  • Henk-Jan HJ Boiten

摘要

Introduction

Both primary and secondary polycythemias can have erythropoietin (EPO) levels that overlap with the normal reference range. Generally, patients with secondary polycythemia have higher EPO concentrations than patients with polycythemia vera.

Case presentation

In clear cell renal cell carcinoma (ccRCC) increased EPO levels have been documented. However, we report the case of a 73-year-old man with polycythemia secondary to ccRCC, who presented with a normal serum EPO level.

Conclusion

ccRCC should always be considered in the differential diagnosis of polycythemia even with normal EPO levels. This case highlights that a normal EPO level does not exclude an underlying neoplasm. Imaging should be promptly considered as part of the diagnostic work-up.