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.

Close-up view of cutaneous metastasis of clear cell renal cell carcinoma.

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