Facial papules, spontaneous pneumothorax, and renal tumors

CASE SUMMARY History A 68-year-old woman was referred for evaluation of multiple white to skin-colored papules distributed over her face, neck, and upper trunk. She had a history of right-sided spontaneous pneumothorax that occurred in 1990 and recurrent spontaneous pneumothorax in 1991, at which time she underwent pleurodesis. In 1992, a computed tomographic (CT) scan of abdomen and pelvis revealed a 34-cm tumor on her left kidney. She underwent left partial nephrectomy and pathologic examination revealed an oncocytic neoplasm. Her family history was significant for multiple relatives with “skin bumps” (Fig 1).