Renal cell carcinoma (RCC) has been well described for its frequency to metastasize. Cutaneous facial lesions as the primary presentation of RCC is, however, extremely rare. We present clinical, radiographic, and histologic images of a 40-year-old man who presented with a cutaneous facial lesion that was diagnosed as metastatic RCC after excisional biopsy. A subsequent computed tomography demonstrated a small mass (3.5 × 2.6 cm) in the midpole of the right kidney. Partial nephrectomy with histologic analysis confirmed RCC, clear cell type.
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