Review Question - QID 214919

A 66-year-old man presents to the emergency department with red-tinged urine for the past 3 days. He denies fever, chills, pain with urination, or urinary urgency. His medical history includes hypertension, hyperlipidemia, chronic obstructive pulmonary disease, and diabetes. His medications include amlodipine, atorvastatin, tiotropium, and metformin. He currently smokes 1 pack of cigarettes per day and has a 50 pack-year smoking history. His temperature is 99.3°F (37.4°C), blood pressure is 136/88 mmHg, pulse is 80/minute, and respirations are 16/minute. Physical exam reveals a thin-appearing man with bitemporal wasting. There is no costovertebral angle tenderness or palpable abdominal masses. A CT scan shows a heterogeneously-enhancing 6.3 cm x 5.6 cm mass at the upper pole of the right kidney with thick septa. Which of the following additional findings is most likely to be observed?