Genitourinary System Disorders Practice Test

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Renal cell carcinoma can cause polycythemia through ectopic erythropoietin production. Which hematologic change does this cause?

Polycythemia due to ectopic erythropoietin production

Ectopic erythropoietin production by a renal cell carcinoma stimulates red blood cell production in the bone marrow, leading to polycythemia. EPO acts on erythroid precursors to boost erythropoiesis, so tumor-derived EPO raises the red cell mass and hemoglobin/hematocrit levels, independent of oxygen needs. This is a classic paraneoplastic syndrome of RCC. The other options describe scenarios with reduced red cells or other cell lines, which don’t fit this mechanism: decreased EPO causing anemia, or changes in platelets or white cells are not the typical RCC paraneoplastic presentation.

Anemia due to decreased erythropoietin production

Thrombocytopenia due to platelet consumption

Leukopenia due to marrow suppression