Histopathologic examination demonstrated an intradermal tumor nodule composed of groups of clear cells with abundant clear cytoplasm and oval nucleus in a glandular configuration. The stroma was highly vascular, with many extravasated red blood cells. The findings were consistent with metastatic renal cell carcinoma. Subsequent computed tomography of the abdomen revealed a huge heterogeneous mass in the left kidney, consistent with renal cell carcinoma (Figure 3). A complete blood cell count revealed only mild anemia (hemoglobulin, 12.4 g/dL [reference range, 13.5-17.5 g/dL]). No gross or microscopic hematuria was noted. The results of all other laboratory tests were within normal limits.
A Slowly Growing Ulcerated Nodule on the Scalp—Diagnosis. Arch Dermatol. 2004;140(11):1393-1398. doi:10.1001/archderm.140.11.1393-d