Renal derived epistaxis

Metastatic Renal Cell Carcinoma to the Head and Neck Area

AIMS AND BACKGROUND

Metastases of renal cell carcinoma to the head and neck are rare. We report on three cases with tumor spread to this area (nasal cavity, tongue and larynx) and present a review of the literature.

PATIENTS

The first patient presented with lung and nasal cavity metastases five years after renal tumor resection. In patient 2 the diagnosis of primary renal carcinoma and lung and tongue metastases was concomitant. In case 3 a primary kidney tumor was not suspected until radical resection of a tongue lesion was performed.

RESULTS

The first two patients received radiation therapy. They had been previously treated with interleukin + interferon and vinblastine + interleukin 2 and achieved a survival of 14 and 16 months, respectively. The third patient has not been given any treatment to date (apart from surgery) and remains asymptomatic four years after diagnosis.

CONCLUSIONS

In patients with cell carcinoma the occurrence of lesions in the head and neck area may suggest metastases. In some cases they may precede the diagnosis of a renal tumor and mimic a primary head and neck tumor; otolaryngologists should be aware of this possibility. An individualized treatment approach is recommended. In the case of solitary metastases a surgical excision should be performed as palliation, if not cure.

Nephrogenic epistaxis

Metastatic renal cell carcinoma (RCC) in the nose and paranasal sinuses is very rare. We report an unusual case of metastatic RCC that presented as recurrent epistaxis ten years after curative nephrectomy. The purpose of this report is to draw the attention of clinicians to the possibility of metastatic RCC in patients with recurrent epistaxis and nasal mass. We also discuss treatment options and review the relevant literature.

Renal cell carcinoma metastasis to the paranasal sinuses and orbit

The authors report a rare case of renal cell carcinoma (RCC) metastasis to the paranasal sinuses. The authors review RCC and its potential for sinonasal metastasis and discuss the variable presentation and need for clinical suspicion for early diagnosis and treatment. A 74-year-old man presented with numbness of the left side of the face, reduced visual acuity and ptosis 12 years after nephrectomy for RCC. Imaging studies showed a lesion in the left pterygopalatine fossa and the histological features supported the diagnosis of metastatic RCC. RCC metastasis to the paranasal sinuses is very rare and can present with various symptoms depending on the affected organ. These symptoms occasionally are the initial manifestation of renal RCC and it is very important to recognise them so that the patient receives the appropriate therapy to improve survival.

[Unusual metastasis of renal carcinoma]

Renal carcinoma, the third most common urological cancer, induces presence of metastases in 75% of cases. The most affected sites for metastasis are the lungs, the lymphatic system, bones, the liver, adrenal glands and the brain with sometimes a cancer free period of several years prior to evolutionary recurrence of the disease. The aim of this literature review is to report on secondary uncommon renal localizations by underlining their clinical significance, as well as main characteristics, in order to provide guidelines for effective patient diagnosis and therapeutic management.

Metastatic renal cell carcinoma presenting with epistaxis

Renal cell carcinoma is a slow growing malignancy of the kidney that has a high propensity for metastasis. It is the most common metastasis reported in the paranasal sinuses. A fifty six year old male patient, an operated case of left renal cell carcinoma presented seven years later with epistaxis. Computerized tomography of the paranasal sinuses and of the abdomen showed a metastatic lesion involving the left nasosinus region and a lesion involving the right kidney with lung metastasis, respectively. Due to the poor prognosis palliative radiotherapy was given.

A Rare Case of Renal Cell Carcinoma Metastatic to the Sinonasal Area

We report a rare case of a hypernephroma that had metastasized to the sinonasal area as a solitary mass. Despite much difficulty, a confirmatory biopsy of the nasal mass was obtained. After radiotherapy had failed to arrest the tumor's growth, the mass was removed via a craniofacial resection. This case illustrates the importance of(1)a high index of suspicion in differentiating this rare tumor from other benign or malignant diseases, (2) awareness of the risk of hemorrhage and the role of preoperative embolization, (3) the need for paraffin histology rather than fine-needle aspiration or frozen section diagnosis, (4) individualizing therapy after due consideration of the characteristics of both the patient and the tumor, and (5) keeping abreast of the most current therapeutic modalities so that patient management can be individualized and optimized. Surgical excision offers the best hope for long-term survival, and it reduces the degree of pain, epistaxis, and disfigurement from the expanding tumor. When such tumors are not resectable, management with radiotherapy, hormonal therapy, immunotherapy, or chemotherapy can be considered.

Renal cell carcinoma: a paradigm of lanthanic disease

Renal cell carcinoma is characterized by varied and sometimes obscure manifestations, which include unusual metastatic sites and paraneoplastic and vascular syndromes. In this review, uncommon metastatic sites and their clinical significance are discussed, particularly the thyroid, nasal structures, vagina, and gastrointestinal sites. Paraneoplastic syndromes appear to be related predominantly to cytokines or immunologic mechanisms. Vascular syndromes are related to the tendency of the tumor to spread by direct venous extension and to complications related to the vascularity of the tumor or its metastases. The recognition of unusual manifestations of renal cell carcinoma is important because these syndromes may lead to the diagnosis. Moreover, paraneoplastic syndromes and vascular findings may not indicate unresectability or incurability.

Metastatic osteosarcoma of the ethmoid: an unusual cause of recurrent epistaxis and proptosis

Osteosarcoma is the most common primary malignant tumour of bone and it usually metastasises to the lung. In the nasal cavity metastatic disease is extremely rare. We describe a case of osteosarcoma presenting with recurrent epistaxis, and proptosis due to secondaries in the nasal cavity. To our knowledge such a case has not been reported previously in the available English literature.

Renal cell carcinoma presenting as a solitary paranasal sinus metastasis

We present an unusual case of renal cell carcinoma presenting as a periorbital mass. The presenting symptom was a supraorbital swelling which proved to be a mucocoele which had arisen secondary to a solitary metastasis in the ethmoidal sinuses. We discuss the management strategy including the place of endoscopic biopsy, the choice of investigations and craniofacial resection.