Deepak Verma,Antony Mathew,Rose-Anne Nunoo,Mekha Maria John,Mudit Jain,Syeda Nabila Ali, Acrometastasis as the First Presentation of Renal Cell Carcinoma International Journal of Surgical Case Reports 2023 2674-4171 http://dx.doi.org/10.31487/j.IJSCR.2023.01.01 https://www.sciencerepository.org/acrometastasis-as-the-first-presentation_IJSCR-2023-1-101 Abstract: Acrometastasis is the term used to describe secondaries present distal to the knee or elbow [1-3]. The occurrence of this is extremely rare. This accounts for 0.1% of all secondaries to the bone [1-5]. The presence of acrometastasis is considered to be a sinistrous sign and correlates with the advanced stage of the disease condition [1, 2, 5]. The majority of acrometastasis is from lung and gastrointestinal malignancies [1-3]. We present a case of a gentleman in his early 60’s, who presented with acrometastasis as the first sign of renal cell carcinoma.Keywords: Finger swelling, acrometastasis, renal cell carcinoma