Transitional cell carcinoma metastasis to arm skin from the renal pelvis

Metastases of renal pelvic transitional cell carcinoma (TCC) to the skin and subcutaneous tissues are extremely rare. Similar to metastases from other genitourinary tract organs, they commonly affect middle-aged or elderly men, generally herald a rapid progression, and are associated with a poor outcome. Skin metastatic lesions present as painful or nontender nodules, and a vascular or even a zosteriform appearance may occasionally be noted. The latter is often confused with herpes zoster infection. The diagnosis is usually confirmed by histopathological findings of biopsy specimens. Cutaneous metastases generally carry a dismal prognosis, with survival of only several months. We herein present a case of renal pelvic TCC with cutaneous metastases to the bilateral arms and epigastric region 1.5 years after diagnosis of the primary lesion. The patient's condition rapidly deteriorated, and she expired 4 weeks later. We present this rare case to highlight the possibility of cutaneous metastases from renal pelvis TCC and with the hope to increase awareness of the rapidly fatal course of such patients.