Cutaneous metastasis as the first sign of renal cell carcinoma – crossroad between literature analysis and own observations

Abstract

Introduction: Metastatic disease can be observed in nearly 25% of all renal cell carcinoma cases (RCC). This can present in the skin as a late symptom of the disease or as a manifestation of an undetected, asymptomatic RCC. Aim: To review the literature and present a case study of cutaneous metastasis in primary genitourinary malignancy, especially RCC in order to broaden the related knowledge. Material and methods: The first stage of our work was focused on presenting the results of the literature review about cutaneous metastasis in the patients with renal cell carcinoma. Next, taking into account that this type of metastasis associated with RCC is relatively rare, we have decided to present a patient aged 68 with incidentally detected skin metastases of RCC located on the scalp. Results: It was diagnosed as a primary manifestation of advanced disease. Computed tomography scans showed a solid mass in the left kidney. Following surgical excision of the skin lesion, a left-side nephrectomy was performed. Conclusions: Cutaneous metastases of RCC present an unfavourable prognosis, however, remission is possible subsequent to early diagnosis and appropriate surgical excision.

Pembrolizumab combined with axitinib in the treatment of skin metastasis of renal clear cell carcinoma to nasal ala: A case report

“…Skin metastasis from renal carcinoma mostly occurs in the scalp, rarely in the nasal ala[ 2 ]. Balawender et al [ 3 ] reported cases of cutaneous metastasis of renal cell carcinoma from 2000 to 2019, with only two cases of nasal cutaneous metastasis.…”

Cutaneous Metastasis of Sarcomatoid Renal Cell Carcinoma, A Clinicopathologic Challenge

“…2,3 Most cases of SRCC are diagnosed at an advanced stage with more than 60% of cases presenting with metastases at the time of diagnosis. 4 Due to the increased risk of early dissemination to multiple organs, the overall survival rates are significantly impacted and tend to be lower than the conventional type. 5 SRCC usually metastasizes to various organs, including the lungs, bone, brain, and liver.…”

Cutaneous metastasis of a sarcomatoid–rhabdoid renal tumor to a distal phalanx

“…1 Nonetheless, up to 1/3 of CM are diagnosed prior to or simultaneously with the primary malignancy. 1 The main tumors to metastasize to the skin are melanoma, as well as lung and breast adenocarcinomas. 2,3 On the contrary, even though 25% of renal cell carcinomas (RCC) associate metastasis at diagnosis, cutaneous involvement is exceptional and usually associated with a very poor prognosis.…”

“…2,3 On the contrary, even though 25% of renal cell carcinomas (RCC) associate metastasis at diagnosis, cutaneous involvement is exceptional and usually associated with a very poor prognosis. 1,4 Similarly, and regardless of existing CM, sarcomatoid and rhabdoid dedifferentiation in renal tumors are also well known poor prognostic factors. 4 Clinically, CM usually present as rapidly growing subcutaneous lesions frequently located in proximity to the primary tumor.…”

“…4 Clinically, CM usually present as rapidly growing subcutaneous lesions frequently located in proximity to the primary tumor. 1,3 In contrast, CM to the nail unit/distal phalanx are highly uncommon, making up a scarce 1% of all acral metastases, and are usually distant to the primary neoplastic site, which is usually the lung, followed by the kidneys. 5,6 Additionally, this type of CM usually affects one single digit of the upper extremities.…”