{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T06:27:40Z","timestamp":1786429660833,"version":"build-2736575974"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast metastases from extramammary malignancies are rare, and those originating from renal cell carcinoma (RCC) are exceptionally uncommon. These lesions often follow an indolent course, delaying recognition until acute, life-threatening complications such as hemorrhagic rupture occur. The lack of standardized management guidelines further impedes timely intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>An 88-year-old woman with a history of radical nephrectomy for clear cell RCC 20\u202fyears prior presented with active hemorrhage from a spontaneously ruptured right breast mass. Two years earlier, a 2.5\u202f\u00d7\u202f1.5\u202fcm nodule (BI-RADS 3) had been detected but managed conservatively without biopsy, gradually enlarging over the following two years. On admission, physical examination revealed a large, tender mass (\u223c6.5\u202f\u00d7\u202f6\u202f\u00d7\u202f7.5\u202fcm) with skin erythema, ulceration, and active bleeding. CT demonstrated the breast mass and revealed two additional imaging-suspected lesions: a right pulmonary nodule and a right adrenal mass. After hemodynamic stabilization, right simple mastectomy was performed, achieving definitive hemostasis. Histopathology and immunohistochemistry (CAIX+, PAX-8+, vimentin+; GATA-3-, GCDFP-15\u2212, ER\u2212, PR\u2212) confirmed metastatic clear cell RCC. The patient declined systemic therapy. At 30-month telephone follow-up, she reported no symptomatic local recurrence or new symptoms; however, no postoperative imaging was performed to confirm this.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case illustrates a critical two-stage progression of breast metastasis from RCC\u2014indolent growth followed by rapid enlargement and hemorrhagic rupture. It underscores that while a BI-RADS 3 lesion in an RCC survivor may be managed with standard short-interval imaging, any interval enlargement or morphological change should prompt a lower threshold for tissue confirmation. An IHC panel (PAX-8\/CAIX positivity with negative breast-specific markers) is essential for confirming metastatic RCC. The absence of postoperative imaging in this case\u2014with follow-up limited to symptom-based telephone assessment\u2014highlights the critical importance of radiological surveillance to objectively evaluate disease status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1859653","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:34:40Z","timestamp":1786426480000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneously ruptured breast metastasis from renal cell carcinoma 20\u202fyears post-nephrectomy: a case report and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Chengmin","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Surgery, Changxing People\u2019s Hospital","place":["Changxing, Huzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Changxing People\u2019s Hospital","place":["Changxing, Huzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiufeng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology, Changxing People\u2019s Hospital","place":["Changxing, Huzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuchao","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Changxing People\u2019s Hospital","place":["Changxing, Huzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1111\/his.14141","article-title":"Histological clues to the diagnosis of metastasis 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