Ianny Brum Reis, Milena Moraes de Carvalho, Danilo Paschoal Ferrarezi, Natalie Aparecida Rodrigues Fernandes, Camyla Rodrigues Nascimento, Álvaro Formoso Pelegrini, Aldenora Maria Ximenes Rodrigues, Alex de Freitas Porsani, Flávio Ferlin Arbex, Carlos Rossa Junior
When a presumed renal infection is culture-negative, antibiotic-refractory, associated with progressive anemia, and radiologically non-resolving, malignancy should be suspected early. The presence of an irregular solid enhancing component and vascular involvement on CT are malignancy-specific red flags that should not be overlooked. A bear-paw-like appearance does not exclude RCC. Short-interval failure of antibiotic therapy (7-10 days) should trigger surgical exploration or tissue diagnosis rather than prolonged empirical treatment.
We report a rare case of cutaneous metastasis from oral squamous cell carcinoma (OSCC). The primary tumor showed low expression of Galanin, CD68, GALR2, and Collagen IV, with increased FOXP3 and Vimentin. Systemic analysis revealed reduced CD8+ cells and increased Tregs. The patient died following aggressive disease progression.