Late cutaneous metastasis of clear-cell renal cell carcinoma to the lower eyelid five years after radical nephrectomy: A case report

Abstract

Clear-cell renal cell carcinoma (ccRCC) metastasises widely, but cutaneous spread is uncommon and eyelid involvement exceptionally rare. We report a 55-year-old man who developed a painless 4-mm lower-eyelid nodule five years after curative left radical nephrectomy for pT1a ccRCC. Excision confirmed metastatic ccRCC (PAX8+, CD10⁺). Staging showed mediastinal nodal and pulmonary disease. First-line avelumab 800 mg IV every two weeks plus axitinib was initiated; in July 2025 axitinib was reduced to 5 mg once daily. After eight cycles, interim CT (August 2025) demonstrated regression with no locoregional recurrence. This case highlights continued vigilance and prompt biopsy of atypical eyelid lesions.