[Expert Solution]: A 66 year-old man comes to the office…

A 66 year-old man comes to the office because he has had swelling of his scrotum for the past week. Medical history includes hypertension, which is managed with lisinopril and hydrochlorothiazide. The patient smokes one pack of cigarettes daily. Heart rate is 88 per minute and blood pressure is 136/84. Other vital signs are within normal limits. Physical examination of the scrotum shows varicocele on the right that is nontender to palpation, and does not change in size when the patient is moved to the supine position. On further questioning of this patient about his history, which of the following additional findings, best supports a suspected diagnosis of renal cell carcinoma? A gross hematuria for the past three days B pain in the upper back for the past six months C urinary frequency for the past four weeks D urinary tract infection two weeks ago or E weight gain over the past six months?