title: Coexistent metastatic melanoma of the kidney with unknown primary and renal cell carcinoma.
abstract: In this report, we present an African-American female patient who presented with haematuria to her primary care physician. The symptoms persisted and coexistent metastatic spindle cell-type melanoma of the kidney and renal cell carcinoma were discovered on further evaluation. No primary site for melanoma was identified. Despite aggressive treatment with ipilimumab, the patient's disease progressed quickly. The patient opted for palliative care and was referred to a hospice. Coexistent melanoma and renal cell carcinoma is exceedingly rare. Melanoma itself is rare in the African-American population. However, when it does present, it usually is at an advanced stage, as was the case in our patient. Since no primary tumour site for melanoma was found and the diagnosis was made after the tumour had metastasised, we think this case highlights the importance of cutaneous cancer surveillance in the non-Caucasian population. Earlier identification of melanoma in this population will help to improve outcomes.
authors.affiliation: St. Louis University, St Louis, Missouri,  USA.
authors.forename: Maulik
authors.initials: M
authors.lastname: Dhandha
authors.forename: Melinda B
authors.initials: MB
authors.lastname: Chu
authors.forename: John M
authors.initials: JM
authors.lastname: Richart
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D000074324:Ipilimumab; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D008545:Melanoma / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy*; D010166:Palliative Care
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000074324:Ipilimumab