Renal cell carcinoma (RCC) is most commonly identified incidentally from imaging for unrelated abdominal conditions but may also present with local symptoms, paraneoplastic syndromes or symptoms from metastatic disease. Common sites of metastasis include lung, lymph nodes and bone. Rarer sites of spread include cerebral and cutaneous metastases; distant disease in the oral cavity and facial skin has been described. 1 Patients who present with atypical lesions can present a diagnostic dilemma; histopathological analysis with immunohistochemistry is usually needed to confirm the underlying primary malignancy. We present a case of a patient presenting with symptomatic, synchronous metastases from a primary RCC with lesions at different sites in the absence of symptoms related to the undiagnosed primary tumour.