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.