Rare Case of Renal Cell Carcinoma with Mandibular Swelling as Primary Presentation

Abstract

Introduction. Renal cell carcinoma accounts for approximately 3% of adult malignancies and 90–95% of neoplasms arising from the kidney. This disease is characterized by a lack of early warning signs, diverse clinical manifestations, and resistance to radiation and chemotherapy. Approximately one-third of patients with renal cell carcinoma have metastatic disease at initial presentation. Fifteen percent of patients with renal cell carcinoma are said to present with metastases in the head and neck region. Most of the metastases from RCC to the head and neck involve the thyroid gland. The head and neck are unusual sites for metastases, but skin, skeletal muscle, thyroid gland, nasal cavity and paranasal sinus metastases have been reported. Case Report. The following report describes a rare case where the patient presented with mandibular swelling of short duration as the primary complaint without any symptom or sign pertaining to urinary tract and was found to have renal cell carcinoma on further workup. Conclusion. Metastatic renal cell carcinoma is a diagnostic dilemma especially when there is no pointer historically towards renal cell carcinoma as was in our case. An unusual vascular osteolytic lesion in head and neck in a middle-aged person should be dealt with high index of suspicion with renal cell carcinoma at the back of the mind.

Solitary parotid metastasis 8 years after a nephrectomy for renal cell carcinoma

“…Tumor cells can also bypass the pulmonary capillary filtration altogether via Batson's plexus, a network of valveless veins that connect the deep pelvic veins and thoracic veins to the vertebral column or brain. This seems to be the case in our patient given the absence of lung involvement ( 7 , 8 ).…”

Isolated temporalis muscle metastasis of renal cell carcinoma

“…So, pulmonary metastasis frequently occurs along this route. Tumor cells can also bypass pulmonary capillary filtration altogether via Batson plexus (cerebrospinal venous system), a network of valveless veins that connect the deep pelvic veins and thoracic veins to the vertebral column or brain without traversing the lungs [ 6 , 7 ]. This seemed to be the case in our patient, given the absence of lung involvement.…”

Secondary or Second Primary Malignancy in the Thyroid? Metastatic Tumors Suggested Clinically: A Differential Diagnostic Task

“…In the scientific literature, many cases of metastatic tumors in the thyroid have been published as case reports describing the pitfalls of individual case diagnosis supported by a literature overview, stressing the specific context of the more frequent primary malignancies or the reporting a rare malignancy metastasizing to the thyroid [11,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31]. Meta-analyses are available for the most frequent primary malignancies [32,33].…”