title: Atypical presentation of calvarial metastasis of renal cell carcinoma in an adolescent: A rare case diagnosed on fine needle aspiration cytology with literature review.
abstract: Renal cell carcinoma (RCC) is a complex and challenging neoplasm both in terms of treatment as well as diagnosis. Its unpredictable biological behavior and many deceptive appearances can sometimes bewilder the pathologist. We hereby report a rare case of a 17 year old girl presenting with an occipital swelling and importantly no prior documents at the time of aspiration. Fine needle aspiration cytology showed features of metastatic carcinoma with the following possibilities; metastatic RCC, melanoma, and hepatocellular carcinoma. Further detailed history of the patient and investigations were advised. Intraoperative squash smears also showed similar features. Histopathology of the lesion showed features of metastatic RCC. This case highlights the fact that a skull lesion in rare cases may be the presenting sign of an underlying malignancy. In the absence of key documents, providing the correct diagnosis may become very challenging and cytomorphology alone can be extremely helpful.
authors.affiliation: Department of Pathology and Neurosurgery, GB Pant Hospital and Associated Maulana Azad Medical College, Delhi, India.
authors.forename: Kavita
authors.initials: K
authors.lastname: Gaur
authors.forename: Shramana
authors.initials: S
authors.lastname: Mandal
authors.forename: Ranjana
authors.initials: R
authors.lastname: Gondal
authors.forename: Daljit
authors.initials: D
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D044963:Biopsy, Fine-Needle; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000556:secondary; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012886:Skull / Q000473:pathology*; D012888:Skull Neoplasms / Q000175:diagnosis* / Q000556:secondary
keywords: adolescent; calvarium; metastasis; renal cell carcinoma