title: Pathological clavicular fracture as first presentation of renal cell carcinoma: a case report and literature review.
abstract: Renal cell carcinoma (RCC) accounts for approximately 3% of all cancer cases. RCCs usually metastasize to the lungs, bones, liver, or brain. Only <1% of patients with bone metastases manifested clavicular RCC metastases. Thus, clavicular metastasis as the initial presentation of RCC is extremely rare. We report a patient with RCC metastasis to the left clavicle, which was first presented with pain caused by a pathological fracture. Magnetic resonance image revealed a renal tumor, and technetium-99m-methylene diphosphonate bone scintigraphy showed multiple osseous metastases. The patient eventually underwent surgery to remove the lateral end of the left clavicle and right kidney. Histopathology revealed renal tumor and clear cell carcinoma in the clavicle. Finally, we review 17 cases of clavicular metastases originating from different malignancies.
authors.affiliation: 1 Department of Medical Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 2 Department of Orthopedics, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 3 Postgraduate School, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Kong
authors.affiliation: 1 Department of Medical Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 2 Department of Orthopedics, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 3 Postgraduate School, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.affiliation: 1 Department of Medical Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 2 Department of Orthopedics, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 3 Postgraduate School, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Li
authors.affiliation: 1 Department of Medical Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 2 Department of Orthopedics, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 3 Postgraduate School, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Guo
authors.affiliation: 1 Department of Medical Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 2 Department of Orthopedics, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 3 Postgraduate School, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Jian-Fa
authors.initials: JF
authors.lastname: Xu
authors.affiliation: 1 Department of Medical Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 2 Department of Orthopedics, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China ; 3 Postgraduate School, Tianjin Medical University, Tianjin 300070, China.
authors.forename: He-Lin
authors.initials: HL
authors.lastname: Feng
keywords: Clavicle; metastasis; pathological fracture; renal cell carcinoma (RCC)