Amyloidosis in the Context of Renal Cell Carcinoma: A Case Report and Literature Review.

This case study details an 86-year-old male with a history of hypertension, dyslipidemia, and bilateral blindness, who presented with recurrent vomiting and a progressive proteinuric acute kidney injury. Initial evaluations revealed nephrotic syndrome and acute kidney injury, alongside imaging findings consistent with a renal mass, later confirmed as grade 3 clear renal cell carcinoma (RCC) upon biopsy. Concurrently, systemic amyloid A (AA) amyloidosis was diagnosed based on the result of the kidney biopsy. Despite multidisciplinary management, the patient's renal function progressively deteriorated because of AA amyloidosis associated with RCC. His admission was complicated by community-acquired pneumonia. Owing to the high risk of surgical intervention and the inability to perform radiofrequency ablation because of the tumor's location, curative treatment was not feasible, and the patient was transitioned to palliative care. This case report aims to highlight the pathophysiology, clinical presentation, diagnosis, and management of AA amyloidosis secondary to RCC. The literature review underscores the rarity of this association and the challenges in diagnosing and treating such cases. Emphasis is placed on the importance of early recognition and integrated management strategies to optimize patient outcomes, particularly in elderly patients with complex medical conditions.