PMC8349284_01
X-ray anteroposterior/lateral view of the leg showing destruction of the distal tibia.
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fig1
Ankle X-rays (anterior-posterior and lateral views) were performed and demonstrated an osteolytic lesion within the medial malleolus and distal tibial metaphysis (Figure 1).
Computed tomography showed a solid mass measuring 40 x 36 x 30 mm in the right kidney.
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fig2
A tumor of the right kidney was identified and presumed to be renal cell carcinoma (Figure 2).
(a-d) The micrograph of a clear cell renal cell carcinoma H&E stain. This image demonstrates the optically clear tumor cells with uniform small nuclei without nucleolar ranged in an alveolar pattern. Cells with clear cytoplasm, typically arranged in nests. Nuclear atypia is common. Water-clear or optically clear cells (due to glycogen content) arranged in nests in "chicken wire" vasculatures. Visible subcapsular changes in the area of the kidney cortex. Numerous extravasations are visible in the vascular glomeruli (a, b). Metastasis of renal cell carcinoma. Histological microphotograph showing neoplastic cells with prominent nucleoli. Ankle joint and metastasis of renal cell carcinoma H&E sections (c, d). Scal bar: (a) 200 mum; (b-d) 100 mum. The samples were analyzed morphologically and photographed under an Olympus BX43 light microscope equipped with an Olympus SC50 digital camera.
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fig3
The histopathologic report confirmed the diagnosis of ccRCC pT1b with angioinvasion with negative surgical margins, WHO/ISUP Grade 2 (Figure 3). The biopsy was completed without complication, and histologic diagnosis confirmed a metastasis of ccRCC (CD10+, vimentin+, TTFI-, RCC+, and PAX8+; Figure 3).