Introduction: This is a retrospective case report of atypical acute retinal necrosis (ARN), describing a rare presentation of ARN in an immunocompetent adult, with choroidal, optic nerve, and orbital inflammation with exudative retinal detachment (ERD), complicated by early rhegmatogenous retinal detachment (RRD). Case report: Examination revealed right eye granulomatous panuveitis, including granulomatous anterior chamber inflammation, dense vitreous haze, and peripheral necrotizing hemorrhagic retinitis. Optical coherence tomography (OCT) showed inner retinal hyperreflectivity, thickened choroid, and ERD. Magnetic resonance imaging (MRI) confirmed inflammation of the optic nerve sheath and orbital tissues. Polymerase chain reaction (PCR) confirmed varicella-zoster virus (VZV) infection. Left eye showed an old peripheral chorioretinal scar. Patient received systemic acyclovir, oral trimethoprim-sulfamethoxazole, along with systemic corticosteroids and intravitreal ganciclovir. Final resolution of ERD and improvement in orbital and intraocular inflammation were observed. The patient subsequently developed early RRD, managed by pars plana vitrectomy (PPV) and silicone oil tamponade. Despite structural stabilization, visual recovery was limited due to late presentation, optic nerve, and choroidal involvement. Systemic investigations excluded alternative causes.Conclusions: ARN with concurrent panocular inflammation, choroidal, and optic nerve involvement is uncommon and may indicate a more aggressive disease course, often associated with poor visual prognosis. This case highlights that ARN with choroidal and optic nerve involvement may follow an aggressive course, requiring early PCR confirmation, intensive antiviral therapy, and timely surgical intervention to prevent severe visual loss

Introduction: This is a retrospective case report of atypical acute retinal necrosis (ARN), describing a rare presentation of ARN in an immunocompetent adult, with choroidal, optic nerve, and orbital inflammation with exudative retinal detachment (ERD), complicated by early rhegmatogenous retinal detachment (RRD). Case report: Examination revealed right eye granulomatous panuveitis, including granulomatous anterior chamber inflammation, dense vitreous haze, and peripheral necrotizing hemorrhagic retinitis. Optical coherence tomography (OCT) showed inner retinal hyperreflectivity, thickened choroid, and ERD. Magnetic resonance imaging (MRI) confirmed inflammation of the optic nerve sheath and orbital tissues. Polymerase chain reaction (PCR) confirmed varicella-zoster virus (VZV) infection. Left eye showed an old peripheral chorioretinal scar. Patient received systemic acyclovir, oral trimethoprim-sulfamethoxazole, along with systemic corticosteroids and intravitreal ganciclovir. Final resolution of ERD and improvement in orbital and intraocular inflammation were observed. The patient subsequently developed early RRD, managed by pars plana vitrectomy (PPV) and silicone oil tamponade. Despite structural stabilization, visual recovery was limited due to late presentation, optic nerve, and choroidal involvement. Systemic investigations excluded alternative causes.Conclusions: ARN with concurrent panocular inflammation, choroidal, and optic nerve involvement is uncommon and may indicate a more aggressive disease course, often associated with poor visual prognosis. This case highlights that ARN with choroidal and optic nerve involvement may follow an aggressive course, requiring early PCR confirmation, intensive antiviral therapy, and timely surgical intervention to prevent severe visual loss

Introduction: Cutaneous metastases from RCC is an uncommon and poorly understood clinical phenomenon that frequently predicts a poor prognosis. Case presentation: A 69-year-old male with a history of type 2 diabetes and benign prostatic hyperplasia (BPH) was diagnosed with stage 4 renal cell carcinoma (RCC) and various cutaneous lesions. A dermatological checkup during his hospitalization revealed asymptomatic subcutaneous nodules and purpuric areas. Biopsy and immunohistochemistry (IHC) staining confirmed the presence of cutaneous metastatic carcinoma, which is consistent with renal cell origin. The immunohistochemistry profile was positive for pancytokeratin, CD10, and vimentin but negative for PAX8, indicating a distinct appearance in RCC patients. Conclusions: This case emphasizes the necessity of recognizing cutaneous metastases as an uncommon presentation of advanced RCC, as well as PAX8's potential role as a diagnostic marker.

Introduction: Cutaneous metastases from RCC is an uncommon and poorly understood clinical phenomenon that frequently predicts a poor prognosis. Case presentation: A 69-year-old male with a history of type 2 diabetes and benign prostatic hyperplasia (BPH) was diagnosed with stage 4 renal cell carcinoma (RCC) and various cutaneous lesions. A dermatological checkup during his hospitalization revealed asymptomatic subcutaneous nodules and purpuric areas. Biopsy and immunohistochemistry (IHC) staining confirmed the presence of cutaneous metastatic carcinoma, which is consistent with renal cell origin. The immunohistochemistry profile was positive for pancytokeratin, CD10, and vimentin but negative for PAX8, indicating a distinct appearance in RCC patients. Conclusions: This case emphasizes the necessity of recognizing cutaneous metastases as an uncommon presentation of advanced RCC, as well as PAX8's potential role as a diagnostic marker.