Whereas metastasis to bone is not uncommon for certain primary tumours, metastasis to the distal appendicular skeleton is extremely rare. Hypernephroma metastasizing to the calcaneum has been described in only a small number of cases and is even less common as the presenting feature of an occult renal cell carcinoma. Highly vascular bone metastases of the calcaneum mimicking vascular malformations are rarer still; to our knowledge there have been no previously reported cases. We present two cases of occult renal cell carcinoma presenting as a vascular lesion of the foot.