Metastatic Renal Cell Carcinoma to the Phalanx

A 79-year-old man presented with a history of clear cell carcinoma of the right kidney, Fuhrman grade 2, 12 years after nephrectomy, and a history of low-risk prostate adenocarcinoma 11 years after brachytherapy. One year before presentation, the renal cell carcinoma had metastasized to his axial skeleton, and temsirolimus was started. Approximately 1 year later, he presented with a new, painful, lytic lesion in a rare site, his middle phalanx, which was biopsy proven to be clear cell carcinoma.