Cutaneous Metastases in Renal Cell Carcinoma

Bujons, Anna; Pascual, Xavier; Martínez, Ricardo; Rodríguez, Ó.; Palou, Juan; Villavicencio, H.

doi:10.1159/000111742

Cited by 28 publications

(23 citation statements)

References 9 publications

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“…Lung parenchyma, bone and liver are the most frequent sites of metastasis whereas brain, pancreas, adrenal, parotid glands and soft tissues such as skin [7] and the muscle tissue are the other sites of less frequent metastasis [5] . Synchronous solitary metastases are detected at the time of the diagnosis of RCC in 2-4% of patients [5] .…”

Section: Discussionmentioning

confidence: 99%

Painful Leg: A Very Unusual Presentation of Renal Cell Carcinoma

Gözen¹,

Canda²,

Naser³

et al. 2009

Urol Int

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Introduction: An unusual case of isolated synchronous solitary gastrocnemius muscle metastases of renal cell carcinoma (RCC) is reported. A review of the literature with particular emphasis on diagnostic and therapeutic approaches is also included and discussed. Material and Methods: A complete review of the English literature using MEDLINE was performed between 1979 and 2008 on RCC and skeletal muscle metastasis. Results: Overall, 23 cases have been reported to have skeletal muscle metastasis by RCC. We report a 58-year-old male patient who was admitted to the orthopedics clinic with a painful left leg swelling. Physical examination revealed a hard mass on his posterior left leg. Magnetic resonance imaging demonstrated a 2 × 4 cm sized mass. Incisional biopsy revealed surprisingly clear cell RCC metastasis. Abdominal radiologic studies demonstrated a 7 × 7 × 6 cm sized left renal mass. Left radical nephrectomy was performed with additional excision of the metastatic mass with negative surgical margins. External radiotherapy to the left leg and 3 cycles of Hannover immunochemotherapy were administered thereafter. The patient was disease-free at the first year of follow-up. Conclusions: Presentation of RCC as a solitary metastasis in the skeletal muscle is a very unusual and poorly documented site of metastasis which can be treated successfully by excision of the metastasis and renal tumor with additional local radiotherapy and immunochemotherapy.

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Section: Discussionmentioning

confidence: 99%

Painful Leg: A Very Unusual Presentation of Renal Cell Carcinoma

Gözen¹,

Canda²,

Naser³

et al. 2009

Urol Int

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“…To our knowledge, cutaneous metastatic disease has not been reported in renal medullary carcinoma. [6][7][8][9][10][11] Here, we present the first case of renal medullary carcinoma metastatic to the scalp.…”

Section: Introductionmentioning

confidence: 94%

Renal Medullary Carcinoma Metastatic to the Scalp

Johnson

Krauland

Owens

et al. 2011

The American Journal of Dermatopathology

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A 40-year-old woman presented to the Brooke Army Medical Center Emergency Department complaining of 2 episodes of gross hematuria. Computed tomography and intravenous pyelogram revealed a right renal mass. A radical nephrectomy was performed with complete excision of the mass with negative margins on histological examination. The patient was diagnosed with renal medullary carcinoma, Fuhrman grade 4, based upon histological examination. A positron emission tomography scan revealed no other evidence of the disease. The pathologic stage was stage I renal medullary carcinoma. Four months after her nephrectomy, the patient developed a papule on her right frontal scalp. Initially thought to be a cyst, the papule increased in size over the course of 2 months and eventually ulcerated. At that time, she presented to the Wilford Hall Medical Center Dermatology Clinic with a 2.5-cm ulcerated tumor with pink rolled borders. A punch biopsy of the tumor revealed an infiltrating carcinoma with scattered glandular lumina and desmoplastic and mucinous stroma. The carcinoma was completely intradermal. Expert consultation confirmed the diagnosis of metastatic renal medullary carcinoma. Clear cell (conventional) and papillary renal cell carcinomas are known to metastasize to the skin, including the scalp. Renal medullary carcinoma commonly metastasizes to the regional lymph nodes, lung, liver, or adrenals. To our knowledge, this is the first report of a cutaneous metastasis of renal medullary carcinoma.

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“…[1,2] There is need for a high index of suspicion in evaluating a patient presenting with a skin tumor, which can be synchronous or metachronous. [2,3] They typically indicate coexistent disseminated disease and a poor prognosis.…”

Section: Isolated Metachronous Cutaneous Metastases From Renal Cell Cmentioning

confidence: 99%

“…The scalp and face are the commonest sites of cutaneous metastases in RCC. [1,2] The proposed mechanisms of cutaneous metastatic dissemination include direct invasion from underlying neoplasm, implantation in an operative scar, lymphatic permeation, and hematogenous spread. [4,5] The clinical appearance of skin metastases can be of 3 types: nodular (majority), inflammatory, and fibrotic.…”

Section: Isolated Metachronous Cutaneous Metastases From Renal Cell Cmentioning

confidence: 99%

“…It usually occurs as a solitary lesion on the face or upper extremities and is composed of 2 types of cells: basaloid cells and shadow cells, present in irregularly shaped islands and separated by a cellular stroma. [1] There is a tendency for basaloid cells to be overrepresented in fine-needle aspiration (FNA) smears, probably because they are more easily detached by the needle. This often leads to an erroneous cytological diagnosis.…”

Section: Pilomatrixoma Misdiagnosed As Round Cell Tumor On Fineneedlementioning

confidence: 99%

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