An upper lip tumour as the presenting symptom of metastatic renal cancer.

Introduction: Renal cell carcinoma (RCC) constitutes about 3% of solid tumours in adults. Unfortunately, in spite of continuous development of more and more efficient diagnostic methods, in about 30% of patients with RCC metastatic spread is found at presentation. Only in 1% of patients with advanced RCC metastases are limited exclusively to the head-and-neck region. We present a case of a male patient in whom a tumour of the upper lip was the first symptom of advanced renal cancer.

Case Report: A 59-year-old male was admitted to the Urology Department due to a large tumour of the right kidney. About two months earlier the patient noted a nodule located within the upper lip. In the same period painless hematuria occurred twice, which was disregarded by the patient. A CT scan of the chest and abdomen showed a large tumour of the kidney, multiple lung and bone metastases. The patient underwent local surgical excision of the lip tumour and palliative renal artery embolization.

Conclusions: In natural history of renal cancer there is a risk of metastatic spread to the head-and-neck region. Contrast enhanced computed tomography of the abdomen should be considered if a tumour of unknown origin is found within the head-and-neck region. Prognosis in case of confirmed metastatic renal cancer is unfavourable and patient's treatment should be conducted in specialist centres.