PDF(Pubmed)
Abstract：
Renal cell carcinoma (RCC) is the most common type of renal neoplasm. It accounts for 3% of solid tumors in adults and mostly affects men with the peak incidence between the fifth and seventh decades. It metastasizes mainly through the hematogenous spread, and the lung is the most common site of metastasis followed by bone, lymph node, liver, brain, and adrenal glands. Skin metastasis is extremely rare and accounts for <7% of RCC metastases, with the scalp and face being the most reported sites. Skin metastases are usually diagnosed at a later stage of the disease, commonly post-nephrectomy, and are regarded as a poor prognostic factor. Here we report a case of a 54-year-old male who presented with a red, pedunculated, bleeding, and nontender scalp lesion (2x2cm in size) found on the right parietal area. with a history of left radical nephrectomy and adjuvant chemotherapy for clear cell RCC 17 years ago, as well as laminectomy and radiotherapy for bone metastases in C5 and C6 in 2015. After surgical excision of the scalp lesion, histology revealed metastatic clear cell RCC. The patient was doing well post-surgical excision and was referred back to oncology where palliative care and supportive treatment were initiated. In the span of five months post-resection, he developed several conditions where his health further deteriorated. He was announced dead in September 2022 due to cardiac arrest. This case highlights the occurrence of scalp metastases long after the surgical resection of RCC.
摘要：
肾细胞癌（RCC）是最常见的肾脏肿瘤类型。它占成人实体瘤的3％，主要影响男性，发病率在第五到第七个十年之间达到高峰。它主要通过血行扩散转移,肺是最常见的转移部位，其次是骨，淋巴结,肝脏,大脑,和肾上腺.皮肤转移极为罕见，占RCC转移的<7％，头皮和面部是报道最多的部位。皮肤转移通常在疾病的晚期被诊断出来，通常是肾切除术后，并被认为是不良的预后因素。在这里，我们报告了一个54岁的男性，有花梗，出血,并在右侧顶叶区域发现非压痛的头皮病变（2x2cm大小）。17年前有左肾根治性切除术和透明细胞肾细胞癌辅助化疗史，以及2015年C5和C6骨转移的椎板切除术和放疗。手术切除头皮病变后，组织学显示转移性透明细胞RCC。患者术后切除情况良好，被转诊至肿瘤科，开始姑息治疗和支持治疗。在切除后的五个月里，他发展了几种情况，使他的健康状况进一步恶化。由于心脏骤停，他于2022年9月宣布死亡。此病例突显了RCC手术切除后很长时间头皮转移的发生。
