Cutaneous Acral Metastasis from Renal Cell Carcinoma-a Case Report

Abstract

Renal cell carcinomas are known to produce widespread and unpredictable metastasis due to their angioinvasive property. Cutaneous metastases from renal cell carcinomas are very rare, with a reported incidence of 1.3-3%. The sites of cutaneous metastasis from renal cell carcinomas, as per the available case reports, to the best of our knowledge, are shoulder, arm, nape of the neck, chest, face and scalp. We report a case of 63-year-old male, with renal clear cell carcinoma with lung metastasis who had cutaneous metastasis to the fingertip which was confirmed by histopathological examination. Apart from its rarity, this clinical case adds another site of renal cell carcinoma metastasis to the present literature. The skin metastasis represents a widely disseminated state of the disease with a very guarded prognosis and limited life span after its diagnosis.

Keywords: Acral metastasis; Cutaneous metastasis; Disarticulation; Renal cell carcinomas.

Fig. 1

a CT chest showing multiple nodular lung lesions, the largest one measures 8.4 × 6.4 cm in the right lower lobe and bulky mediastinal nodes. b Computed tomography (CT) abdomen showing right renal mass 9.7 × 9.8 cm, arising from the interpolar and lower pole of the right kidney

Fig. 2

a Photograph of right little finger tip with a 3 × 2-cm nodular friable bleeding mass. b H&E section (× 400) of the excised finger mass showing neoplasm composed of cells in sheets with abundant clear cytoplasm, consistent with metastasis from clear renal cell carcinoma. c Immunohistochemistry analysis of the finger mass—CD10 membranous positivity. d H&E section (× 400) of bronchoscopic lung biopsy showing neoplasm composed of cells in sheets with abundant clear cytoplasm, suggestive of clear renal cell carcinoma