Which presentation best describes classic renal cell carcinoma?

• A. Cough, dyspnea, chest pain
• B. Edema and ascites
• C. Blood in the urine, abdominal pain, weight loss, and a palpable abdominal or flank mass
• D. Hypertension, headaches, blurred vision

Answer: (C)

Renal cell carcinoma most often presents with the classic triad of hematuria, flank pain, and a palpable abdominal or flank mass, with weight loss and sometimes paraneoplastic features like hypertension or polycythemia. The option describing blood in the urine, abdominal pain, weight loss, and a palpable mass directly matches this pattern. The other choices point toward conditions involving the lungs (cough, chest pain, dyspnea), fluid overload or liver-related issues (edema and ascites), or hypertensive symptoms not specific to RCC, so they don’t fit the typical RCC presentation as well.