Abstract
Metastatic spread from renal cell carcinoma (RCC) can occur in unusual locations, many years after curative nephrectomy. We report the case of a 71-year-old male patient who developed multiple asymptomatic skeletal muscle metastases from RCC, seven years after curative nephrectomy. The lesions were discovered incidentally on CT angiography performed for peripheral artery disease and demonstrated hypervascularity with prominent feeding arteries, consistent with metastatic RCC. Additional pancreatic and pulmonary metastases were also identified on CT. The patient declined further intervention due to poor health status. This case highlights the potential for late, asymptomatic, and unusual metastatic sites in RCC, emphasizing the importance of considering extended surveillance in long-term survivors.