Published online Mar 26, 2023. doi: 10.12998/wjcc.v11.i9.2104
First decision: January 20, 2023
Revised: January 28, 2023
Accepted: February 27, 2023
Article in press: February 27, 2023
Published online: March 26, 2023
Processing time: 72 Days and 7.7 Hours
Renal clear cell carcinoma (RCC) is a malignant tumor of the genitourinary system with a predilection for males. The most common metastatic sites are the lung, liver, lymph nodes, contralateral kidney or adrenal gland, however, skin metastasis has only been seen in 1.0%-3.3% of cases. The most common site of skin metastasis is the scalp, and metastasis to the nasal ala region is rare.
A 55-year-old man with clear cell carcinoma of the left kidney was treated with pembrolizumab and axitinib for half a year after surgery and was found to have a red mass on his right nasal ala for 3 mo. The skin lesion of the patient grew rapidly to the size of 2.0 cm × 2.0 cm × 1.2 cm after discontinuation of targeted drug therapy due to the coronavirus disease 2019 epidemic. The patient was finally diagnosed with skin metastasis of RCC in our hospital. The patient refused to undergo surgical resection and the tumor shrank rapidly after resuming target therapy for 2 wk.
It is rare for an RCC to metastasize to the skin of the nasal ala region. The tumor size change of this patient before and after treatment with targeted drugs shows the effectiveness of combination therapy for skin metastasis.
Core Tip: The skin metastasis of renal cell carcinoma can be diagnosed by pathological biopsy and immunohistochemical staining. The patient’s history, laboratory examination and imaging examination can assist in the diagnosis. The occurrence of skin metastasis often indicates a poor prognosis, and surgical treatment may improve the prognosis. Our patient refused surgery and returned to targeted drug therapy, resulting in significant improvement in skin lesions.