Clear Cell Renal Cell Carcinoma: Rare and Atypical Metastatic Localizations-A Case Series.

Introduction: Clear cell renal cell carcinoma (ccRCC) is the most prevalent subtype of kidney cancer, characterized by its high degree of vascularity and metastatic potential. Although common metastatic sites include the lungs, lymph nodes, bones, liver, adrenal glands, and brain, rare localizations, such as those observed in the pancreas, gallbladder, thyroid gland, and nasal cavities, pose significant diagnostic and therapeutic challenges. Case presentation: The following report details four cases of ccRCC with atypical metastatic localizations: A nasal metastasis in one patient, a thyroid metastasis in one patient, a gallbladder metastasis in one patient, and pancreatic localizations in all four patients. These metastases, frequently asymptomatic, contributed to delays in diagnosis. The therapeutic management of these cases was individualized, incorporating surveillance, surgical intervention, radiotherapy, or immunotherapy, depending on the patient's clinical profile and the progression of the lesions. Conclusion: This series illustrates the diversity of metastatic presentations of ccRCC and highlights the importance of prolonged, personalized follow-up after nephrectomy. A multidisciplinary approach remains essential for the timely detection and optimal management of rare metastatic sites.