Extremely Rare Divergent Differentiation in Sarcomatoid Variant of Renal Cell Carcinoma Developing Lip Metastasis after Radical
Manjeet Kumar, Kalpesh Mahesh Parmar,
Santosh kumar, Ritambra Nada and
Correspondence Address :
Department of Urology, IGMC, Shimla, HP
Received on: April 01, 2019, Accepted on: April 09, 2019, Published on: April 16, 2019
Citation: Manjeet Kumar, Kalpesh Mahesh Parmar, Santosh Kumar, Ritambra Nada, Abhishek Thakur(2019). Extremely Rare Divergent
Differentiation in Sarcomatoid Variant of Renal Cell Carcinoma Developing Lip Metastasis after Radical Nephrectomy.
Copyright: 2019 Manjeet Kumar et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Renal cell carcinoma presents in 25% of patients with metastasis. The skin metastases are infrequent and are usually detected on follow up rather than with initial presentation. Only a few cases of lip metastasis have been reported in literature till date.
We report an extremely rare case of renal cell carcinoma with divergent histopathology presenting as lip metastasis
Case summary: A 75 years old male underwent Radical nephrectomy for Renal mass (T4N0M0). Histopathology was suggestive of a divergent Sarcomatoid variant of renal cell carcinoma. After 3 months of surgery, the patient presented with painless, hard swelling in the upper lip. Excision biopsy confirmed a divergent Sarcomatoid variant of renal cell carcinoma. The patient was started on tyrosine kinase inhibitors however patient succumbed to his aggressive disease after 6 months.
Discussion: Sarcomatoid with divergent pathology of renal cell carcinoma is rare.
Renal cell carcinoma Sarcomatoid variant has aggressive metastatic behaviour. The skin metastases account for 1–3% of all metastases in RCC. The most common sites of metastases to skin reported are scalp and face. The outcome of patients with divergent pathology is dismal.
Conclusion: Metastasis to lip is a rare occurrence presenting in advanced carcinoma. Despite aggressive treatment, the prognosis is poor in divergent pathology of RCC.
Keywords: RCC, Lip metastasis, Divergent, Nephrectomy, Sarcomatoid.