Abstract

Background: Renal cell carcinoma (RCC) although can present as metastatic disease in almost one third of cases, it presenting as solitary bone lesion as primary sign and symptom is rare event accounting for 0.7%-2.5% only. Bone metastasis mostly presents as bone pain due to lytic lesion or rarely as fracture of axial bone. In this case report we present, RCC presenting as dislocation of shoulder joint of contra lateral side, to our best knowledge is first reported case of RCC presenting as dislocation of contra lateral shoulder joint. Material and method: Patients had visited in emergency department as severe pain right shoulder. Result: After initial management of dislocation of shoulder, detailed evaluation and diagnostic work up was done and patient was diagnosed of left renal tumour. Biopsy of bone lesion was reported as metastatic adenocarcinoma and bone scan revealed it to be solitary metastatic lesion. Patient underwent left radical nephrectomy for renal mass and biopsy was reported as clear cell carcinoma. For shoulder metastasis radiotherapy treatment was started. Patient recovered well post operatively with advice for regular follow up and plan to start immunomodulator treatment at later date. Conclusion: High degree of suspicion in patient presenting as bone pain, fracture of long bones and even dislocation of major joint, especially in young patient with presence of lytic bone lesion, for presence of genitourinary tumour.