Ann Dermatol.  2008 Dec;20(4):263-266. 10.5021/ad.2008.20.4.263.

A Case of Metastatic Renal Cell Carcinoma Mimicking Granuloma Pyogenicum

• Jin WW
• Chung JM
• Jung KE
• Park JW
• Kim MH

• KMID: 2156411
• DOI: http://doi.org/10.5021/ad.2008.20.4.263

Abstract

Renal cell carcinoma (RCC) is well known for its frequent metastasis and particularly to the lungs, liver, bones and brain, but metastasis to the skin is rare. We report here on a case of metastatic RCC in a 73-year-old man who presented with a 1.5 cm sized, moist, beefy-red and exophytic nodule on the scalp. The lesion had grown rapidly for 2 months and it clinically mimicked granuloma pyogenicum. A skin biopsy revealed a solid mass composed of clear cells with clear cytoplasm and oval hyperchromatic nuclei, and they were arranged in an alveolar pattern. As skin metastasis from renal cell carcinoma signals widespread systemic metastasis and a poor prognosis, clinicians should conduct a careful inspection of the skin of a patient with RCC and they should also have a high index of suspicion for finding a primary internal organ malignancy in the RCC patients who present with a skin lesion.

Keyword

Granuloma pyogenicum; Metastatic renal cell carcinoma; Scalp

MeSH Terms

Aged
Biopsy
Brain
Carcinoma, Renal Cell
Cytoplasm
Granuloma
Granuloma, Pyogenic
Humans
Liver
Lung
Neoplasm Metastasis
Prognosis
Scalp
Skin

Figure

• 

  Fig. 1 A 1.5×1.5 cm sized, moist, beefy-red and exophytic nodule was found on the vertex.

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  Fig. 2 (A) The nodule was composed of clear cells with hyperchromatic nuclei and abundant clear cytoplasm (H&E, ×100). (B) The nests of clear cells were arranged in a honeycombed or glandular configuration (H&E, ×400).

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  Fig. 3 The cytoplasm of the tumor cells stained positive for EMA (×400) (A) and cytokeratin (×400) (B).

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