The ear biopsy comprised small fragments of skin and underlying soft rissue, together measuring 3 mm in diameter, in which there were a few groups of carcinoma cells. They had granular cytoplasm, contained glycogen but neither mucin nor other specific features. The specimen from the even biopsy of the temporal bone comprised two fragments of soft tissue, respectively 12 and 2 mm long.
Microscopic examination revealed a carcinoma composed of an alveolar arrangement of cells, some of which resembled thọse of the first biopsy. However, most displayed clear cytoplastn, and the appearance was considered typical of metastatic renal cell carcinoma. The kidney weighed 250g and included a 20 mm diameter tumour in the middle, close to the hilum, also with the characteristic pattern of a renal cell carcinoma. A subsequent biopsy of a pathological fracture of the femur again showed identical tumour tissue.
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