Introduction

Cutaneous metastases from renal cell carcinoma are rare, with a reported prevalence of 2.8–6.3% of cases. These lesions can clinically mimic a wide range of infectious conditions, vascular proliferations, and adnexal tumors, including bacillary angiomatosis, pyogenic granuloma, Kaposi’s sarcoma, and eccrine acrospiroma.

Case report

A middle-aged man with a history of non-metastatic renal cell carcinoma, previously treated with nephrectomy, remained in remission during therapy with cabozantinib and lenvatinib. Abrupt discontinuation of targeted therapy was followed by the rapid development of angiomatous skin nodules after a prolonged disease-free interval. Initially interpreted as vascular tumors, the lesions were subsequently identified as cutaneous metastases of clear cell renal cell carcinoma. The patient deteriorated rapidly and died shortly thereafter.

Conclusions

This case highlights the importance of maintaining a high index of suspicion for cutaneous metastases in patients presenting with seemingly benign angiomatous skin lesions, particularly those with a history of renal cell carcinoma. Early diagnostic evaluation, including prompt skin biopsy, is essential to distinguish these lesions from their clinical mimics. Recognition of cutaneous metastases is crucial, as they represent a rare but grave prognostic indicator associated with poor outcomes in renal cell carcinoma.