Neurointervention.  2020 Nov;15(3):162-166. 10.5469/neuroint.2020.00206.

Embolization of an Exophytic Posterior Neck Mass Secondary to a Cutaneous Renal Cell Carcinoma Metastasis

• Kramer DE
• Kerolus MG
• Tan LA
• Patel S
• Reddy V
• Chen M

• KMID: 2508070
• DOI: http://doi.org/10.5469/neuroint.2020.00206

Abstract

Renal cell carcinoma (RCC) commonly metastasizes to the lung, liver, bones, and brain; however, cutaneous metastases remain rare with few reported cases. Since RCCs have the propensity to metastasize to highly vascular areas, the scalp and skin of the head and neck region are likely locations for cutaneous metastases. We report a rare case of a large, exophytic, cauliflower-like, hemorrhagic, metastatic mass of the posterior neck. This is the first reported case of a head and neck cutaneous RCC metastasis treated with endovascular embolization prior to surgical resection. Due to the increased vascularity of RCCs and risk of excessive hemorrhage during resection, adjunctive embolization of cutaneous head and neck metastasis may have a role. Essential characteristics to our treatment strategy are discussed with a review of pertinent literature.

Keyword

Cutaneous metastasis; Embolization; Exophytic mass; Neck mass; Carcinoma, renal cell

Figure

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  Fig. 1. (A) Photograph of the patient’s posterior neck demonstrating a large, exophytic, cauliflower-shaped, grey-tan in color neck mass continuous with a yellow-tan nodule in the subcutaneous tissue measuring a 5.7×5.0 cm with hemorrhage originating from the necrotic center. (B) T1-weighted magnetic resonance imaging of the neck revealed an exophytic, cutaneous neck mass without involvement deep to the fascia. (C) Digital subtraction angiography (DSA) of the right external carotid artery (ECA) demonstrating the primary blood supply to the mass from the right occipital artery. (D) DSA of the left ECA demonstrating the primary blood supply to the mass from the left occipital artery. (E) An unsubtracted image of the Onyx cast. (F) Gross specimen of the cauliflower shaped mass measuring approximately 5.7×5.0 cm.

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