Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2023; 11(9): 2104-2109
Published online Mar 26, 2023. doi: 10.12998/wjcc.v11.i9.2104
Pembrolizumab combined with axitinib in the treatment of skin metastasis of renal clear cell carcinoma to nasal ala: A case report
Shuai Dong, Yang-Chun Xu, Yuan-Chen Zhang, Jian-Xin Xia, Yan Mou
Shuai Dong, Yang-Chun Xu, Yuan-Chen Zhang, Jian-Xin Xia, Yan Mou, Department of Dermatology, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
Author contributions: Dong S collected the data, did the literature searching and contributed to the manuscript drafting; Xu YC, Zhang YC and Xia JX did the follow-up and contributed to the manuscript drafting; Mou Y was the patient’s doctor, and revised and reviewed the manuscript; all authors gave final approval for the version to be submitted.
Supported by the National Natural Science Foundation of China, No. 81803160.
Informed consent statement: Informed consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist, and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Yan Mou, Doctor, MD, PhD, Associate Professor, Senior Consultant Dermatologist, Department of Dermatology, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130041, Jilin Province, China.
Received: January 4, 2023
First decision: January 20, 2023
Revised: January 28, 2023
Accepted: February 27, 2023
Article in press: February 27, 2023
Published online: March 26, 2023

Renal clear cell carcinoma (RCC) is a malignant tumor of the genitourinary system with a predilection for males. The most common metastatic sites are the lung, liver, lymph nodes, contralateral kidney or adrenal gland, however, skin metastasis has only been seen in 1.0%-3.3% of cases. The most common site of skin metastasis is the scalp, and metastasis to the nasal ala region is rare.


A 55-year-old man with clear cell carcinoma of the left kidney was treated with pembrolizumab and axitinib for half a year after surgery and was found to have a red mass on his right nasal ala for 3 mo. The skin lesion of the patient grew rapidly to the size of 2.0 cm × 2.0 cm × 1.2 cm after discontinuation of targeted drug therapy due to the coronavirus disease 2019 epidemic. The patient was finally diagnosed with skin metastasis of RCC in our hospital. The patient refused to undergo surgical resection and the tumor shrank rapidly after resuming target therapy for 2 wk.


It is rare for an RCC to metastasize to the skin of the nasal ala region. The tumor size change of this patient before and after treatment with targeted drugs shows the effectiveness of combination therapy for skin metastasis.

Keywords: Skin metastasis, Renal clear cell carcinoma, Pembrolizumab, Axitinib, Case report

Core Tip: The skin metastasis of renal cell carcinoma can be diagnosed by pathological biopsy and immunohistochemical staining. The patient’s history, laboratory examination and imaging examination can assist in the diagnosis. The occurrence of skin metastasis often indicates a poor prognosis, and surgical treatment may improve the prognosis. Our patient refused surgery and returned to targeted drug therapy, resulting in significant improvement in skin lesions.