Background: Renal cell carcinoma with isolated metastasis to the parotid gland is extremely rare. Slow growth, low level of suspicion and negative Fine needle aspiration cytology (FNAC) often delay the diagnosis. A high level of suspicion of metastatic disease from a specic site is important, otherwise can be missed for a benign swelling leading to delayed treatment and poorer prognosis. A 59-year-old Case presentation: male presented with a swelling in the right preauricular area 5 years post right radical nephrectomy for right renal cell carcinoma (RCC). The examination was suggestive of a benign swelling. FNAC was done twice, which was inconclusive. A Tru-cut biopsy of the lesion revealed metastatic RCC. MRI revealed a dumbbell type of tumor extending deep into the gland and encasing vessels. PET-CT was negative for metastasis to the rest of the body. The patient received targeted therapy followed by radiation therapy with imaging showing non-progression of the disease. Conclusion: Metastatic disease should be considered whenever a parotid mass is detected in patients with an RCC history. Examination ndings can be misleading; hence dedicated imaging is critical. Small parotid metastasis can be cured with surgery. A combination of chemotherapy and radiation therapy can palliate the unresectable disease.

Introduction: Renal Cell Carcinoma (RCC), a highly vascular tumor may present with rare metastasis at initial presentation. Synchronous breast metastasis from clear cell renal cell carcinoma is very rare and correlates with poor prognosis. In absence of any renal complaints, a breast lump can mimic a primary breast carcinoma or benign breast disease. A 55-year-old fema Case History: le, presented with a swelling in the right breast. Physical examination was suggestive of a benign swelling in view of well-dened margins, no lymphadenopathy, no skin changes. Fine needle aspiration cytology was done twice and was inconclusive. Tru-Cut biopsy revealed metastatic RCC. Mammography showed BIRADS-IV lesion and PET-CT revealed oligometastatic disease with breast and a small solitary lung metastasis. The patient underwent simultaneous right cytoreductive nephrectomy and lumpectomy. Early detection and surgical resecti Conclusion: on of limited metastatic disease is important, as the treatment instituted at an earlier stage when it is amenable to surgical resection improves the survival considerably

Giant hydronephrosis is mostly caused by ureteropelvic junction obstruction (UPJO). Giant hydronephrosis with concurrent malignancy is less common clinically and is easily misdiagnosed. We report a 77-year-old male who presented with sudden onset progressive abdominal distension in the last month. Abdominal computed tomography showed a right severe hydronephrotic kidney with loss of parenchymal thinning. Cystoscopy showed a 1x1cm papillary lesion protruding from the right ureteric orifice. He underwent a right radical nephroureterectomy with bladder cuff excision with lymph node dissection. Histopathology showed low-grade urothelial carcinoma of the ureter and incidental pleomorphic rhabdomyosarcoma in the right kidney. The patient refused chemotherapy and died 6 months later due to lung metastasis. Incidental pathologic finding of renal rhabdomyosarcoma in adults with giant hydronephrosis and urothelial carcinoma is a rare occurrence with diverse clinical presentations, prognoses, and outcomes.