An atypical cutaneous complication
A nodular skin lesion on the scalp of a patient lost to follow-up is a rare sign of sinister spread
Betty, a 64-year-old female, presents to ED with a nodular lesion on her superior scalp.
The nodule has been present for several months and is causing pain, irritation, bleeding and distress because of cosmetic concerns.
Three months prior, Betty had presented to ED with two weeks of lethargy, fever, right-sided flank pain, pleuritic chest pain and unintentional weight loss of 20kg over the preceding two months.
A CT chest, abdomen and pelvis identified a right necrotic renal mass and three parenchymal lung nodules, consistent with metastatic renal cell carcinoma.
