Metastatic Renal Cell Carcinoma Presenting as Nasal Mass: Case Report and Review of Literature

Mahajan, Ritesh; Mayappa, Nagaraj; Prashanth, V.

doi:10.1007/s12070-015-0959-8

Cited by 10 publications

(21 citation statements)

References 14 publications

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“…RCC has many variants, although the clear‐cell (conventional) type is the most common. Biopsy of metastatic RCC may be inconclusive because of diffuse necrosis of the lesion . Light microscopic findings in clear‐cell RCC include the presence of polygonal tumor cells with cytoplasmic clearing arranged in sheets or acini, with a prominent, delicate fibrovascular stroma; often, associated hemorrhage and necrosis are visible on both gross and microscopic examination.…”

Section: Primary Tumor Sitesmentioning

confidence: 99%

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Metastases to nasal cavity and paranasal sinuses

et al. 2016

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The sinonasal cavities are rare locations for metastases. Metastases to these locations are usually solitary and produce similar symptoms to those of a primary sinonasal tumor. Nasal obstruction and epistaxis are the most frequent symptoms. The maxillary sinus is most frequently involved. The most common primary tumor sites to spread to this region originate in the kidney, breast, thyroid, and prostate, although any malignancy could potentially lead to a metastasis to the paranasal sinuses. The patient's prognosis is usually poor because of the fact that the sinonasal metastasis is usually associated with widespread disseminated disease. In the majority of patients, palliative therapy is the only possible treatment option. Nevertheless, whenever possible, surgical excision either alone or combined with radiotherapy may be useful for palliation of symptoms and, rarely, to achieve prolonged survival. This review considers the most interesting cases reported in the literature that presents metastases to the sinonasal cavities. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1847-1854, 2016.

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Section: Primary Tumor Sitesmentioning

confidence: 99%

“…Postnephrectomy patients who develop a single metachronous metastasis may benefit from surgery and even aggressive surgical resection has been recommended . Several authors report successful treatment of solitary metastases with craniofacial resection .…”

Section: Primary Tumor Sitesmentioning

confidence: 99%

Metastases to nasal cavity and paranasal sinuses

et al. 2016

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“…Sinonasal metastases are quite rare; however, RCC is the most common malignancy that metastasizes to this area [3]. Common sites of RCC metastases are the lungs, the liver, the adrenal glands, the brain, and bones.…”

Section: Discussionmentioning

confidence: 99%

“…После патохистолошке потврде метастазе карцинома бубрега потребно је спровести радиолошко испитивање мале карлице, абдомена и грудног коша како би се искључила даља дисеминација малигне болести. Кључне речи: eпистакса; карцином бубрега; метастаза тумора; носна шупљина Понављајуће крварење из носа као манифестација синоназалне метастазе карцинома бубрега Миљан Фолић 1,2 , Александар Тривић 1,2 , Бојан Павловић 1,2 , Иван Боричић 1,3 , Јовица Миловановић 1,2…”

Section: Discussionunclassified

“…Клинички центар Србије, Клиника за оториноларингологију и максилофацијалну хирургију, Београд, Србија; 2 Универзитет у Београду, Медицински факултет, Београд, Србија;3 Универзитет у Београду, Медицински факултет, Институт за патологију, Београд, Србија…”

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Recurrent epistaxis as manifestation of renal cell carcinoma sinonasal metastasis

Folić¹,

Trivić²,

Pavlović³

et al. 2019

Srp Arh Celok Lek

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Introduction Renal cell carcinoma is the most frequent infraclavicular primary tumor metastasizing in the sinonasal region, although these metastases are not common. We present an unusual case of recurrent epistaxis as the initial sign of renal carcinoma sinonasal metastasis and discuss the diagnostic and treatment options. Case outline A 66-year-old patient was admitted to the hospital due to recurrent and severe epistaxis. The patient underwent nephrectomy due to renal cell carcinoma, with no signs of relapse during a three-year follow-up. Nasal endoscopy and computed tomography revealed a large mass in nasal cavity, spreading to the anterior and posterior ethmoid cells, sphenoid sinus, orbit, and anterior cranial fossa. Definite diagnosis of renal cell carcinoma metastasis in sinonasal region was made by a pathologist after biopsy and further radiological examination showed no signs of malignant disease in the abdomen, thorax, or pelvis. Although the patient had received 50 Gy of radiation therapy, the malignant disease was evaluated as progressive with further extension in anterior cranial fossa and maxilla, and the patient died five months after the occurrence of epistaxis. Conclusion In patients with recurrent epistaxis who also had a history of renal carcinoma, endoscopic finding of tumefaction in the nasal cavity should raise a suspicion of sinonasal metastasis. In such cases, biopsy is mandatory to differentiate a metastasis from primary sinonasal tumors. Histological confirmation should be followed by radiological examination of the abdomen, thorax, and pelvis to evaluate the possibility of renal cell carcinoma recurrence or metastatic dissemination elsewhere.

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