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Updated: Jun 11, 2025
Comparing Metastatic Clear Cell Renal Cell Carcinoma Model Established in Mouse Kidney and on Chicken Chorioallantoic Membrane
Published on: February 8, 2020
Clear cell renal cell carcinoma micrometastasis: Insights from an unconventional cutaneous presentation
Mohammad Fardos1, Heather Kopecky1, James Sligh2
1HCA Healthcare/USF Morsani College of Medicine GME-HCA Florida Largo Hospital Largo Florida USA.
Abstract:
Clear cell renal cell carcinoma (ccRCC) is a highly lethal cancer known for its propensity to metastasise, yet the mechanisms underlying metastasis are not well defined. Cutaneous metastases from ccRCC are uncommon and typically occur within 3 years post-nephrectomy, predominantly affecting the scalp, chest or abdomen. Here, we present a unique case of a 75-year-old male, previously treated for ccRCC with right radical nephrectomy, who developed a singular skin lesion on the left side of the neck 19 years post-nephrectomy. The lesion was confirmed as metastatic ccRCC through histopathological analysis, despite negative imaging findings. Micrometastases, characterised by microscopic tumour cell foci in distant sites, pose a significant diagnostic challenge, frequently evading detection on conventional imaging modalities like computed tomography and magnetic resonance imaging. This case contributes to our understanding of ccRCC metastasis, emphasising the necessity for continued clinical vigilance and thorough diagnostic scrutiny, particularly concerning atypical metastatic sites.
Insights
This case study highlights a rare instance of clear cell renal cell carcinoma (ccRCC) metastasis to the neck skin 19 years post-surgery. It underscores the challenge of detecting micrometastases, even with advanced imaging.
Area of Science:
- Oncology
- Dermatology
- Pathology
Background:
- Clear cell renal cell carcinoma (ccRCC) is an aggressive cancer with poorly understood metastatic pathways.
- Cutaneous metastases from ccRCC are rare, typically appearing within 3 years of nephrectomy on the scalp, chest, or abdomen.
Purpose of the Study:
- To report a unique case of ccRCC cutaneous metastasis to the neck occurring 19 years post-nephrectomy.
- To emphasize the diagnostic challenges posed by micrometastases and atypical metastatic sites.
Main Methods:
- Case report of a 75-year-old male with a history of ccRCC and right radical nephrectomy.
- Histopathological analysis of a singular skin lesion on the left neck.
- Review of conventional imaging findings (CT, MRI) which were negative for metastasis.
Main Results:
- A solitary skin lesion on the left neck was confirmed as metastatic ccRCC.
- The metastasis occurred 19 years after the initial nephrectomy, an unusually late presentation.
- Standard imaging modalities failed to detect the micrometastatic disease.
Conclusions:
- This case expands the understanding of ccRCC's metastatic potential and latency.
- Highlights the importance of clinical vigilance and thorough histopathological examination for diagnosing rare, late-onset cutaneous metastases.
- Underscores the limitations of conventional imaging in detecting micrometastases.
