title: Rare metastatic sites of renal cell carcinoma: urethra and spermatic cord.
abstract: BACKGROUND
  About 20% of patients with a diagnosis of primary renal cell carcinoma (RCC) present directly with metastatic disease. The aim of the present manuscript is to describe, for the first time a RCC metastasis located to the distal female urethra and to present an update on metastatic locations to the male spermatic cord.
  
  
  METHODS
  We report two cases of rare RCC metastases. The first concerns a 92-year-old female patient who came to our attention for recurrent urethral bleeding, which was initially believed to be secondary to urethral mucosal ectropion. Pathology demonstrated a RCC metastasis. The second concerns a 67-year-old male patient with a previous history of RCC who came to our attention for the finding of palpable, mobile and indolent right inguinal lump. Given the past history of malignancy, it was excised and revealed to be a RCC metastasis.
  
  
  CONCLUSIONS
  In the first case, the pathologic specimen allowed the detection of an unknown renal tumor, whereas in the second, the previous neoplastic history of the patient has led clinicians to focus on a possible neoplastic recurrence, perform a correct excision of the node, and begin an early systemic therapy.
  
  
  CONCLUSIONS
  These cases are emblematic of possible unexpected RCC metastasis. These findings should be taken into account in order to clarify the differential diagnosis and to address these patients to a correct therapeutic course.
authors.affiliation:  Department of Urology, University of Modena and Reggio Emilia, Modena - Italy.
authors.forename: Giacomo M
authors.initials: GM
authors.lastname: Pirola
authors.affiliation:  Department of Urology, University of Modena and Reggio Emilia, Modena - Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Martorana
authors.affiliation:  Department of Urology, University of Modena and Reggio Emilia, Modena - Italy.
authors.forename: Francesco A
authors.initials: FA
authors.lastname: Fidanza
authors.affiliation:  Department of Pathology, University of Modena and Reggio Emilia, Modena - Italy.
authors.forename: Luca Reggiani
authors.initials: LR
authors.lastname: Bonetti
authors.affiliation:  Department of Urology, University of Modena and Reggio Emilia, Modena - Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Puliatti
authors.affiliation:  Division of Anaesthesiology and Intensive Care Unit, Department of Surgery, Azienda Ospedaliero-Universitaria of Modena, Policlinico, Modena - Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bonora
authors.affiliation:  Department of Urology, University of Modena and Reggio Emilia, Modena - Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Micali
authors.affiliation:  Department of Urology, University of Modena and Reggio Emilia, Modena - Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Bianchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000556:secondary*; D005260:Female; D005834:Genital Neoplasms, Male / Q000556:secondary*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D013085:Spermatic Cord; D014523:Urethral Neoplasms / Q000556:secondary*