F 59 with left renal mass, lower lip biopsy.

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Diagnosis: 
Metastatic renal cell carcinoma in the skin
Comment:

Cutaneous metastases from carcinoma are uncommon in clinical practice.
Breast, stomach, lung, uterus, large intestine, and kidneys
are the most frequent organs to produce cutaneous metastases.
Cancers with the highest propensity to metastasize to the skin include melanoma (45% of cutaneous metastasis cases) and breast (30%).
Cutaneous metastasis signals widespread metastatic disease, and a poor prognosis.
Renal cell carcinoma may metastasize to scalp and operative scars.
Because of the prominent vascularity of the renal cell carcinoma, lesions may mimic a hemangioma or a pyogenic granuloma.

         Ref:  Sarma DP, Wang JF, McAllister MV, Wang B, Shehan JM. (2008) Possible implantation carcinoma of the scalp following craniotomy for metastatic renal cell carcinoma. Dermatology Online J 14(6):20. PMID: 18713600 [PubMed – indexed for MEDLINE]

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