<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2007-4085</journal-id>
<journal-title><![CDATA[Revista mexicana de urología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. mex. urol.]]></abbrev-journal-title>
<issn>2007-4085</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Mexicana de Urología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2007-40852018000300220</article-id>
<article-id pub-id-type="doi">10.24245/revmexurol.v78i3.1641</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Manifestación atípica de carcinoma renal de células claras. Reporte de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Atypical presentation of clear cell renal cell carcinoma. A case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[León-Castorena]]></surname>
<given-names><![CDATA[Emilio de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez-Vallejo]]></surname>
<given-names><![CDATA[Selene Daneyda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Autónoma de Coahuila  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Autónoma de Coahuila  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2018</year>
</pub-date>
<volume>78</volume>
<numero>3</numero>
<fpage>220</fpage>
<lpage>224</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2007-40852018000300220&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2007-40852018000300220&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2007-40852018000300220&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  CASO CLÍNICO:  Paciente masculino de 60 años que acudió al servicio médico por una neoformación de 3 meses de evolución, localizada en la región occipital del cuero cabelludo, dolorosa, con hipersensibilidad y sangrado fácil a la manipulación. A la exploración física se encontraron signos vitales normales. Se observó una tumoración esférica de 4 x 4 x 3 cm en la región occipital, eritematosa, bien delimitada, de bordes regulares, consistencia blanda, discretamente móvil, alopecia y costra serohemática en su centro, acompañada de dolor a la palpación. El diagnóstico sugerente fue quiste triquilemal o pilar; sin embargo, el ultrasonido evidenció una tumoración sólida, de ecogenicidad heterogénea, vascularizada al doppler. El estudio histopatológico reportó una neoplasia con patrón morfológico compatible con metástasis por carcinoma renal de células claras. En el posoperatorio, la tomografía evidenció la coexistencia de una neoplasia en el riñón derecho, con características radiológicas de carcinoma de células claras en etapa IV (T4N1M1) y múltiples lesiones nodulares sólidas compatibles con metastasis parenquimatosa pulmonar bilateral. El paciente se valoró con enfermedad renal terminal y decidió descontinuar su tratamiento; se observó deterioro importante en el estado general y falleció poco tiempo después por enfermedad metastásica diseminada.  CONCLUSIONES:  La metástasis al cuero cabelludo puede simular un quiste triquilemal y acompañarse de alopecia neoplásica. Las metástasis cutáneas de carcinoma de células claras son difíciles de identificar, pues se asemejan a las dermatosis comunes, por lo que su índice de sospecha es bajo y representan un signo de mal pronóstico, pues sugieren afectación multiorgánica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  CLINICAL CASE:  A 60-year-old man sought medical attention for a painful, hypersensitive neoformation of 3-month progression located at the occipital region of the scalp, that bled easily upon manipulation. Physical examination revealed normal vital signs. A 4 x 4 x 3-cm soft, erythematous, slightly mobile, well-defined sphere-shaped tumor was observed at the occipital region, with alopecia. It had regular edges and a serohematic scab at its center and was painful upon palpation. The lesion was suggestive of a trichilemmal or pilar cyst, but ultrasound study identified a solid tumor with heterogeneous echogenicity and Doppler imaging showed vascularization. The histopathologic report stated neoplasia with a morphologic pattern consistent with metastatic clear cell renal cell carcinoma. Postoperative tomography showed the coexistence of a tumor in the right kidney, with radiologic characteristics of stage IV clear cell renal cell carcinoma (T4N1M1) and multiple solid nodular lesions consistent with bilateral pulmonary parenchymal metastasis. The patient developed end-stage renal disease and decided to discontinue treatment. He had important deterioration in his general state of health and died shortly thereafter from disseminated metastatic disease.  CONCLUSIONS:  Metastasis to the scalp can simulate a trichilemmal cyst and be accompanied by neoplastic alopecia. Cutaneous metastases from clear cell renal cell carcinoma are difficult to identify because they resemble common dermatoses, resulting in a low rate of suspicion. They are a sign of poor prognosis, given that they suggest the involvement of multiple organs.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Carcinoma de células renales]]></kwd>
<kwd lng="es"><![CDATA[metástasis cutánea]]></kwd>
<kwd lng="en"><![CDATA[Clear cell renal cell carcinoma]]></kwd>
<kwd lng="en"><![CDATA[Metastasis]]></kwd>
<kwd lng="en"><![CDATA[Cutaneous]]></kwd>
</kwd-group>
</article-meta>
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