Possible signs and symptoms of papillary renal cell carcinoma include:  Blood in the urine Low back pain (flank pain) Abdominal pain or swelling Unintended weight loss Fatigue Fever A lump in the side of the abdomen Swelling in the veins around the testicle (varicocele)  Excessive hair growth in women  Pale skin Vision changes  Liver changes  Elevated erythrocyte sedimentation rate (blood test)