Cutaneous metastases in renal cell carcinoma: a case report

Abstract

Renal cell carcinoma is the most common form of malignant renal tumour and is extremely lethal. About 25% of the patients develop metastasis at the time of diagnosis, and in many cases during the course of the disease, affecting the lung, lymphatic ganglions, liver, and bone, with skin metastases being quite rare.A 73-year-old patient, who had undergone surgery for adenocarcinoma in the left kidney 10 years previously, visited the dermatological service due to the appearance of recent, rapidly-developing lesion at the back of his neck. It was decided to remove it surgically. The histological study confirmed clear cell carcinoma that was probably of renal origin. A computed tomography scan was performed on the thorax and abdomen, and lesions were observed that were compatible with metastasis in the right kidney and left lung. Treatment with a multikinase angiogenesis inhibitor (sunitib) was started.Due to the late development of the skin metastases and those in other regions that worsen the prognosis, these patients must be subjected to long-term clinical observation. Urologist should pay attention to cutaneous lesion appearing in these patients as in many times they look like benign lesion.

Figure 1.

(A) A 3.7 cm heterogeneous image in the middle of the right kidney. (B) A 2.5 cm nodule in the lower lobule in left lung. (C) The IHC test showed positive for CD10. (D) Goups of irregular cells with cytological irregularities (large nuclei and prominent nucleoles) and clear cytoplasm are observed in dermis (Hematoxylin-Eosin).