BACKGROUND:

Renal cell carcinoma accounts for 2-3% of the malignant tumors in adult patients. In the United States, 31,000 new cases are reported annually, with a mortality rate of 2.3%. The disease is more common in men than in women (1.5:1). The majority of cases occur in patients between 50-70 years of age. One-third of the tumors present with metastasis at diagnosis (synchronous metastases) and another third will metastasize in the future (metachronous metastases), even as long as 20 years after nephrectomy.

CLINICAL CASE:

A 64-year-old man, with a history of intense smoking and occasional drinking, presented with chronic pain in the index finger of his left hand. A tomography scan suggested a malignant tumor and the lesion was biopsied. The histopathologic report stated metastatic clear cell carcinoma and an abdominopelvic tomography scan identified a clinical stage IV, T2b N0 M1 left kidney tumor. Left radical nephrectomy was performed and the histopathologic result was clear cell renal cell carcinoma. At the follow-up at 2 years, the patient has no additional symptoms and there was no tomographic evidence of local or distant recurrence.

CONCLUSION:

In recent years, the incidence of metastasis from renal carcinoma has increased. In order of frequency, metastases to the lung (60%), bone (20%), liver (8%), and adrenal glands and brain (5%) have been reported. Bone radiology does not exclude the coexistence of metastasis. Some authors suggest making early diagnosis of bone metastasis through scintigraphy versus conventional radiology.