Article Text

Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Steal phenomenon in the lower limb: presentation of a case with osseous metastases secondary to renal cell carcinoma and review of the literature
  1. Mohammed Asha1,
  2. Husam Ibrahim2,
  3. Abdalla Khidir Eisawi3,
  4. Richard Orme4,
  5. Andrew Houghton5
  1. 1
    Department of Neurosurgery, University Hospital of North Staffordshire, Royal Infirmary, Stoke-on-Trent ST4 7LN, UK
  2. 2
    Department of Urology, New Cross Hospital, Wednesfield, Wolverhampton WV10 0QP, UK
  3. 3
    Department of ENT Surgery, New Cross Hospital, Wednesfield, Wolverhampton WV10 0QP, UK
  4. 4
    Department of Radiology, Royal Shrewsbury Hospital, Mytton Pak Road, Shrewsbury SY3 8XQ, UK
  5. 5
    Department of Vascular Surgery, Royal Shrewsbury Hospital, Mytton Oak Road, Shrewsbury SY3 8XQ, UK
  1. A K Eisawi, dreisawi{at}


Renal cell carcinoma is reported to have potent angiogenic activity with a high microvascular density in both primary and metastatic sites compared with other adenocarcinomas. Angiogenesis can lead to the formation of abnormal arteriovenous shunts that can, in patients with peripheral vascular disease, result in worsening of the degree of ischaemia by producing a vascular steal-like phenomena. Nevertheless, steal phenomena secondary to malignancies are extremely rare. We report a case of distal critical limb ischaemia in a patient with peripheral vascular disease exacerbated by massive arteriovenous shunting due to tibial metastases from renal cell carcinoma.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: none.