Asymptomatic Renal Cell Carcinoma Presenting as Clavicle Fracture

Abstract

Abstract Renal cell carcinoma (RCC) accounts for 3% of all cancer cases. The classical triad of hematuria, loin pain, and mass per abdomen is rarely seen. RCC commonly metastasizes to the lungs, bones, and liver. Clavicle metastasis as the sole presentation of RCC is extremely rare. A 61-year-old man presented with pain and swelling over the left clavicle. Imaging revealed a lytic lesion with pathological fracture of the left clavicle, with a histopathological diagnosis of metastasis from clear cell RCC. Subsequent imaging of the abdomen revealed a right kidney mass. He underwent right partial nephrectomy and total left cleidectomy. At 30-month follow-up, he is free of disease with good limb function. Solitary skeletal metastasis from RCC is rare, of which clavicle metastasis as the initial presentation is extremely rare. The overall prognosis of metastatic RCC is poor, emphasizing the importance of identification of the pathological nature of the fracture, for early detection and prompt treatment of the primary tumor in its early stage, thereby improving the chances of overall survival.