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A 63-year-old man was admitted to this hospital because of a mass in the left kidney and pulmonary nodules. The patient had been well until approximately 5 months before admission, when mild nausea, loss of appetite, abdominal pain, and constipation developed, followed by fatigue, weight loss of 3.2 kg, and a nonproductive cough. One month before admission, he saw his primary care physician. Examination revealed scrotal varicoceles that were new and varicosities of both legs that were unchanged from previous examinations; results of the remainder of the examination were normal. Laboratory-test results and radiographs of the upper gastrointestinal tract that
Differential Diagnosis
Radical Nephrectomy
Alternatives to Radical Nephrectomy
Dr. Francis J. Mcgovern's Diagnosis
Pathological Discussion
Discussion of Management
Immunotherapy
Genetic Abnormalities as Targets for Therapy
Clinical Use of Targeted Therapy
Anatomical Diagnosis
Source Information
From the Division of Hematology–Oncology (M.D.M.), the Cancer Center (O.I.), and the Departments of Surgery (F.J.M.), Radiology (M.G.H.), and Pathology (E.O.), Massachusetts General Hospital; the Department of Hematology–Oncology, Beth Israel Deaconess Medical Center (D.F.M.); and the Departments of Medicine (M.D.M., O.I., D.F.M.), Surgery (F.J.M.), Radiology (M.G.H.), and Pathology (E.O.), Harvard Medical School — all in Boston.
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