Discussion
Skin metastasis of renal cell carcinoma signifies advanced disease, and
in the majority of cases it may be accompanied with metastasis to other
organs 4. Patients with cutaneous metastasis have poor
prognosis 5. If a single lesion is present, the 5-year
survival rate is 13-50%. In case of multiple lesions, the 5-year
survival rate decreases to 0-8% 6. Most common sites
for skin metastases in RCC are the scalp and face7 .For localized cutaneous metastasis, local excision
is an option but provides little benefit 7. In cases
of solitary skin metastasis, radiotherapy followed by chemotherapy may
be beneficial 8. Targeted therapy for cutaneous
metastases may include VEGF inhibitors (e.g., bevacizumab)9, tyrosine kinase inhibitors (e.g., sunitinib), or
mTOR inhibitors (e.g., everolimus) 10.
Patients with a history of renal cell carcinoma who are presenting with
abnormal nodular growths on their skin should be followed regularly by a
dermatologist. RCM shows potential as a real-time, non-invasive adjunct
tool for assessing smooth dermal papules/nodules in the setting of
suspected metastasis, melanoma, primary cutaneous malignancies, or
deposition diseases. Although there are no defined RCM diagnostic
features of metastasis, RCM’s ability to detect atypical epidermal and
dermal changes shows its potential in biopsy site selection in cases of
suspected malignancy.