Sternal metastasis as an initial presentation of renal cell carcinoma: a case report.

Renal cell carcinoma accounts for 85% of all solid renal tumors in adults. Nearly one quarter of patients has distant metastasis at presentation while another 50% develop metastasis during follow-up. A small percentage of these are solitary metastasis. We report here a case of solitary bone sternal metastasis as an initial presentation of clear-cell renal cell carcinoma in a 56-year-old woman. The prognosis for patients with metastasized renal cell carcinoma is poor; treatment of metastasis is usually palliative and designed to provide comfort and pain relief. Palliative nephrectomy may be considered for control of symptoms. Radical nephrectomy associated with metastatic bone tumor resection is being tested to improve functional status and survival, especially when metastasis involves supporting bones.