Reversible demyelinating neuropathy associated with renal cell carcinoma

Paraneoplastic neuropathy is a potential complication of renal cell carcinoma. The clinical and electrophysiologic features of such patients have not been well characterized. We describe a patient with a demyelinating neuropathy associated with papillary renal cell carcinoma that resolved following nephrectomy. The literature is reviewed with particular attention to the clinical, electrophysiologic, and kidney histopathologic characteristics of similar patients. Features arguing against other acquired demyelinating neuropathies are highlighted, and we conclude that abdominal imaging may provide important diagnostic data in some patients with evolving demyelinating neuropathies. The significance of papillary renal cell carcinoma (as opposed to clear renal cell carcinoma) is unknown, but may have important pathophysiologic implications.