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Metastasis occurs in 25-50% of patients diagnosed with primary renal cell carcinoma (RCC), although only 6% of RCC metastases manifest on the skin. We present a unique case of a slowly growing clear cell RCC metastasis of the scalp in a middle-aged male that was RCC stain negative. The lesion clinically appeared to be a benign pyogenic granuloma, however, the diagnosis of metastatic clear cell renal cell carcinoma was made based on histology. Because cutaneous metastases may masquerade as other more benign tumors, the physician must be clinically suspicious of vascular appearing lesions on the scalp. 

Renal Cell Carcinoma (RCC) Stain Negative Metastatic Clear Cell Renal Cell Carcinoma Masquerading as a Pyogenic Granuloma on the Scalp