Background: Clear cell sarcoma of the kidney (CCSK) was first recognized from its predilection to metastasize to bone. While there are many case reports in documenting the diagnosis of CCSK by fine needle aspiration cytology (FNAC), this is the first case in which FNAC was instrumental in diagnosing the condition from a metastatic site.
Case: A 2-year-old presented with multiple bone lesions. Fine needle aspirates from these lesions showed a polygonal cell population with eccentrically diagnose both pri placed, lobulated nuclei. The diagnosis of metastatic clear cell sarcoma offered on FNAC prompted a search for the primary renal lesion.
Conclusion: FNAC is a rapid, cost-effective technique and must be used to type pediatric tumors so that an appropriate chemotherapeutic regimen can be commenced promptly.