A Case of Metastatic Renal Cell Carcinoma Mimicking Granuloma Pyogenicum

Abstract

Renal cell carcinoma (RCC) is well known for its frequent metastasis and particularly to the lungs, liver, bones and brain, but metastasis to the skin is rare. We report here on a case of metastatic RCC in a 73-year-old man who presented with a 1.5 cm sized, moist, beefy-red and exophytic nodule on the scalp. The lesion had grown rapidly for 2 months and it clinically mimicked granuloma pyogenicum. A skin biopsy revealed a solid mass composed of clear cells with clear cytoplasm and oval hyperchromatic nuclei, and they were arranged in an alveolar pattern. As skin metastasis from renal cell carcinoma signals widespread systemic metastasis and a poor prognosis, clinicians should conduct a careful inspection of the skin of a patient with RCC and they should also have a high index of suspicion for finding a primary internal organ malignancy in the RCC patients who present with a skin lesion.

Alopecia neoplastica as a sign of visceral malignancies: a systematic review

“…Alopecia neoplastica was diagnosed after the diagnosis of the primary visceral tumour in 72.7% (88/121) cases and only in 2.5% (3/121) cases before the diagnosis of the visceral tumour, while in 24.8% (30/121) cases, the diagnosis was synchronous …”

“…Women were more represented with the 53.7% (66/123) of cases, compared to the 46.3% (57/123) of men . Median age of AN at onset was 59 (IQR: 47–68).…”

“…Regarding the primary site of malignancy, gastrointestinal (GI) tract accounted for 24.4% (30/123), breast for 17.9% (22/123) of cases, kidney for 8.1% (10/123), lung for 7.3% (9/123), thyroid for 7.3% (9/123), uterus for 6.5% (8/123), central nervous system (CNS) for 6.5% (8/123), liver for 3.3% (4/123) and other anatomic areas for 18.7% (23/123) of cases …”

“…Concerning histologic subtype of the primary tumour, carcinoma was the most reported with 53.7% (66/123) cases; of these, 38.2% (47/123) were adenocarcinomas, 7.3% (9/123) were squamous cell carcinomas and 0.8% (1/123) was a small cell carcinoma; while, in 7.3% (9/123) of cases, the type of carcinoma was not further specified . Regarding the remaining cases, 3.3% (4/123) primary tumours were leyomyosarcomas, 1.6% (2/123) were meningiomas, 40.7% (50/123) were other tumour subtypes and in one case of breast cancer, the histologic subtype was unknown (Table ) …”

Embolization of an Exophytic Posterior Neck Mass Secondary to a Cutaneous Renal Cell Carcinoma Metastasis

“…In a retrospective series of 100,453 patients with known malignancies, a total of 77 cases had a cutaneous metastasis of which eight patients had a primary urologic malignancy [ 7 ]. The reported incidence of cutaneous RCC metastasis range from 2.8% to 6.8%, and it is thought to spread primarily via the hematogenous route secondary to the tumor’s high vascularity [ 1 , 8 , 9 ].…”