Polyneuropathy, polymyositis, and myopathy are all known to occur with RCC. The myopathy is characterized by involvement of proximal muscles and association of elevated serum levels of creatine kinase and aldolase (Solon etal. 1994; Evans etal. 1990). In each condition, there are reports of resolution after nephrecto-my. With the development of metastatic disease, poly-myositis and polyneuromyopathy have recurred.
Myasthenia gravis is an autoimmune disorder of neural conduction in which the autoantigen is the nico-tinic acetylcholine receptor at the neuromuscular junction. There are few reported cases of carcinomatous neuromyopathies associated with renal cell carcinoma. Neurological manifestations frequently manifest before discovery of the primary tumor. Effective therapy of the primary malignancy is almost always associated with resolution of the symptoms. In one case, the presenting symptom was urinary retention (Torgerson et al. 1999; Leavitt 2000).
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