Cutaneous Metastasis of Renal Cell Carcinoma: An Electron Microscopic Study

Abstract

A case of cutaneous metastasis of renal cell carcinoma in a 67-year-old man is described. Right side nephrectomy had been performed three years earlier, and a renal cell carcinoma was diagnosed. Following a bruise, the patient noticed an erythematous nodule on the scalp. Histological examination of this skin lesion showed atypical tumor cells consisting predominantly of clear cells with a honeycomb-like or adenoid structure. Electron microscopic examination revealed that the tumor cells were divided into three groups: clear cells with abundant glycogen, dark cells with abundant mitochondria, and intermediate cells containing both glycogen and mitochondria in varying proportions. Some of the tumor cells with an adenoid pattern had a brush border-like structure in the lumen. These results support the diagnosis of metastatic renal cell carcinoma. An electron microscopic approach may aid in diagnosis of cutaneous metastasis from renal cell carcinoma.

A Case of Metastatic Renal Cell Carcinoma Mimicking Granuloma Pyogenicum

“…More than half of all cases with cutaneous metastasis from RCC have undergone nephrectomy within 2 years prior to the manifestation of the cutaneous lesions, although in some cases the skin involvement appears after a long interval 7 . One case reported in the literature had undergone radical nephrectomy for RCC 15 years before manifesting skin metastasis 8 .…”

Renal cell carcinoma with skin metastasis

“…Renal cell carcinoma (RCC) accounts for approximately 85% of all primary renal neoplasms; the tumours are usually adenocarcinomas. When renal cell carcinoma is diagnosed, one‐third of subjects already have some metastasis 1–3 . Common distant metastatic sites of RCC are lung, liver and bone.…”

“…Breast cancer is the most common primary tumour that metastasizes in the skin in women, while lung cancer accounts for the majority of cutaneous metastases in men 4,5 . It has been reported that nearly 7% of all cutaneous metastatic tumours are of renal origin 2 . However, skin is a rare site for metastasis of RCC compared to other organs, such as the lung, bone and thyroid 1,6,7 .…”

“…Although the skin is reported to be the seventh most common site of metastatic involvement, immunohistochemical studies are considered able to confirm the correct diagnosis 8,9 . Cutaneous metastasis is generally regarded as a late manifestation; 1,2,8,10 it is frequently found together with lymph node and organ metastases and is seen most often in advanced cases 10 . Metastatic skin lesions can arise anywhere on the body, although the scalp is the most common site, 6,11 and in our case the skin metastasis was on the woman's back.…”

Cutaneous Metastases in Renal Cell Carcinoma

“…The most common sites of metastatic diseases include regional lymph nodes, lung, and bones. A few cases have been reported in the literature [1,2] , pointing to the rarity of cutaneous metastases from renal cell carcinomas and the need for a high index of suspicion in evaluating a patient presenting with a skin tumor. the time of presentation [4] .…”