Case report of a patient with a rare location of renal cell carcinoma metastasis

Abstract

Aim: Renal cell carcinoma is one of the deadliest cancers, takes third place among malignant carcinomas of the genitourinary tract. This case report describes the rare case of a large fast-growing metastasis of renal cell cancer in an unusual location with short time of its appearance, but with unexpected clinical course after its treatment. Case report: A 60-year-old female patient presented with a fist-sized formation on the scalp. During physical examination, the mass was determined to be firm, infiltrative, fixed, and painless upon palpation. The formation had appeared a month prior to arrival, characterized by fast growth. The patient underwent a radical nephrectomy six months earlier due to RCC. A cranial radiogram showed osteolysis of the neurocranium, while an MRI of the brain confirmed the mass belonged to the scalp, no brain infiltration, measuring 82 x 60 x 74 mm. Fine needle aspiration isolated malignant cells of an adenocarcinoma, origin undetermined. The patient underwent surgery to remove the mass along with the effected neurocranium, and the resulting bone defect was reconstructed using Palacos. Postoperative recovery went well, and the pathohistological analysis confirmed renal cancer metastasis. PET-CT didn’t show suspicious lesions for distal metastasis for a period of 2 years. Conclusion: Renal cell carcinoma commonly metastasizes to the lung. This case report presents the rare case of a large fast-growing renal cancer metastasis to an unusual location, with short time for metastasis appearance. In spite of that we have showed two years follow up of remission.