Renal cell carcinoma can presents wide range of signs and symptoms, and commonly associated with paraneoplastic syndrome. Paraneoplastic manifestations are present in up to 20% of patients with renal cell carcinoma. There is convincing evidence that renal cell carcinoma tumor cells elaborate proteins that serve as mediators of endocrine (ex ; ectopic production of parathyroid hormone-related protein or erythropoietin) as well as nonendocrine paraneoplastic syndromes. A paraneoplastic syndrome may be the various clinical presentation of renal cell carcinoma in a significant number of patients, therefore mimicked other general disease. We report a case of renal cell carcinoma associated with paraneoplastic syndrome mimicking pyelonephritis.

Emphysematous pyelonephritis is an uncommon serious suppurative infection, characterized by the production of intrarenal and perirenal gas and can occur in patients with diabetes mellitus or urinary obstruction.

We report our experience with successful management of a case of emphysematous pyelonephritis which occurred in 43 years-old diabetic woman with sepsis and liver cirrhosis. Left nephrectomy was carried out to cure septic crisis.