Difficulties diagnosing psychiatric paraneoplastic syndromes in patients with a psychiatric history: a patient with secondary mania and renal cell carcinoma.

Renal cell carcinoma (RCC) is characterised by lack of early warning signs. The classic triad (palpable mass, haematuria and flank pain) occurs in less than 15% of cases and paraneoplastic syndromes develop in 10-40%, often preceding the detection of the neoplasm. This report describes a 51-year-old woman who displayed manic symptomatology and was investigated due to anaemia. RCC was diagnosed and her psychiatric symptomatology remitted after the nephrectomy.