LAUSR

Eighteen years after undergoing left nephrectomy for the treatment of renal cell carcinoma, a 95-year-old woman presented with a soft subcutaneous mass in the forehead (Picture A). The diameter of the mass was approximately 4 cm and had gradually increased in size. Head computed tomography showed osteolytic lesions in the frontal bone (Picture B and C). Fine-needle aspiration of the mass in the forehead revealed metastasis of renal cell carcinoma. The patient was not administered chemical or radiation therapy owing to severe dementia. Although the forehead mass increased in size, the patient suffered no pain thanks to acetaminophen use. In a previous study, patients without renal cell carcinoma recurrence within 10 years after curative treatment were followed up for 10 to 28 years (median: 13.2 years), and 6.4% of them had delayed recurrence (1). The possibility of metastasis should therefore be considered even after more than 10 years following treatment for renal cell carcinoma.