title: [Carcinoma of the collecting ducts of Bellini: a case report with cutaneous metastasis as the initial clinical manifestation].
abstract: BACKGROUND
  Bellini's collecting ducts carcinoma represents a rare tumor with an aggressive behaviour with a poor prognosis and often metastatic at diagnosis. We report the first case documented of Bellini tumor with an initial clinic presentation represented by a cutaneous metastasis of scalp.
  
  
  METHODS
  All pertinent clinical information were compiled, including patient age, sex, mode of presentation, preoperative laboratory data, radiologic findings, surgery type, macro and microscopic findings, survival data.
  
  
  RESULTS
  After reporting an histopathologic finding of cutaneous metastasis of unknown origin adenocarcinoma with poorly differentiation, a voluminous 6 cm left mesorenal mass is diagnosed through uro-CT. Consequently, it is performed a left radical transperitoneal nephrectomy with consensual exeresis of scalp cutaneous lozenge at the level of previous excision. The histopathologic diagnosis reported was Bellini tumor at stage pT3a-N2-M1. It has not reported significative responsiveness to adjuvant chemotherapy and the patient was died seven months after diagnosis of cutaneous metastasis.
  
  
  CONCLUSIONS
  Most of Bellini’s carcinoma are already metastatic at presentation. Analyzing literature, it is never documented a cutaneous metastasis as first sign at clinical presentation. In this context, radical nephrectomy, differently from others subtypes of advanced renal cell carcinoma, does not seem to improve survival of the patient but rather, it can keep a role in palliation or in the context of new chemotherapeutic protocols.
authors.forename: M
authors.initials: M
authors.lastname: Grande
authors.forename: F
authors.initials: F
authors.lastname: Facchini
authors.forename: M
authors.initials: M
authors.lastname: La Rosa
authors.forename: G L
authors.initials: GL
authors.lastname: Pozzoli
authors.forename: M
authors.initials: M
authors.lastname: Leone
authors.forename: S
authors.initials: S
authors.lastname: Piana
authors.forename: B
authors.initials: B
authors.lastname: Monica
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D009367:Neoplasm Staging; D009392:Nephrectomy; D012878:Skin Neoplasms / Q000188:drug therapy / Q000556:secondary*; D014057:Tomography, X-Ray Computed