Krogerus Christina, Svenning Matilda, Pilt Anette Pedersen, Trøstrup Hannah
Department of Plastic Surgery and Breast Surgery, Zealand University Hospital, Roskilde, Denmark.
Department of Plastic Surgery and Breast Surgery, Zealand University Hospital, Roskilde, Denmark.
Int J Surg Case Rep. 2020;76:56-59. doi: 10.1016/j.ijscr.2020.09.122. Epub 2020 Sep 24.
Renal cell carcinoma (RCC) is often diagnosed as an incidental finding on imaging studies and about a fourth of patients have metastases by the time of diagnosis. RCC is known to metastasize widely but cutaneous metastases are considered uncommon and are rarely the presenting symptom of RCC. We present a case of RCC presenting with a tumor on the scalp.
A 65-year-old healthy man presented with a 9-month history of a growing mass on the scalp. Clinical examination revealed a pulsating, highly vascularized tumor that was excised. Histopathological findings were consistent with a metastasis from a renal cell carcinoma. Further investigations revealed a 13 cm kidney tumor with metastases to the lungs and mediastinum.
Cutaneous metastasis from RCC is uncommon and is rarely the initial symptom of RCC. The lesions often have a vascularized appearance and may be clinically confused with other vascular tumors. Skin metastasis is a sign of advanced disease and prognosis is poor.
An occult RCC may present with a skin lesion. Skin metastasis from RCC is an important differential diagnosis in tumors with a vascular appearance, especially in patients with a previous history of RCC.
肾细胞癌（RCC）常因影像学检查偶然发现，约四分之一的患者在诊断时已有转移。已知RCC可广泛转移，但皮肤转移被认为不常见，很少是RCC的首发症状。我们报告一例以头皮肿物为表现的RCC病例。
一名65岁健康男性，头皮肿物逐渐增大9个月。临床检查发现一个搏动性、血管丰富的肿瘤，遂将其切除。组织病理学检查结果与肾细胞癌转移相符。进一步检查发现一个13厘米的肾肿瘤，已转移至肺和纵隔。
RCC皮肤转移不常见，很少是RCC的初始症状。病变通常有血管丰富的外观，临床上可能与其他血管性肿瘤混淆。皮肤转移是疾病晚期的征象，预后较差。
隐匿性RCC可能表现为皮肤病变。RCC皮肤转移是血管性外观肿瘤的重要鉴别诊断，尤其是有RCC病史的患者。
