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López F, Devaney KO, Hanna EY, Rinaldo A, Ferlito A. Metastases to nasal cavity and paranasal sinuses. Head Neck 2016; 38:1847-1854. [PMID: 27218239 DOI: 10.1002/hed.24502] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 12/19/2022] Open
Abstract
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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Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,University of Oviedo. Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | | | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
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Suojanen J, Färkkilä E, Helkamaa T, Loimu V, Törnwall J, Lindqvist C, Hagström J, Mesimäki K. Rapidly growing and ulcerating metastatic renal cell carcinoma of the lower lip: A case report and review of the literature. Oncol Lett 2014; 8:2175-2178. [PMID: 25289097 PMCID: PMC4186528 DOI: 10.3892/ol.2014.2505] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 05/23/2014] [Indexed: 12/14/2022] Open
Abstract
Renal cell carcinomas (RCCs) have a tendency to metastasize at an early stage, therefore, the patients frequently exhibit metastatic disease at the time of diagnosis. Common locations for the metastases are adjacent organs and abdominal lymph nodes; however, occasionally metastasis to the peripheral organs may be the initial clinical symptom. The 71-year-old male patient in the current case suffered from radioresistant and aggressively behaving RCC metastasis in the mandible and lower lip, which was successfully managed by surgical resection. RCC metastasis to the facial area is considered to be uncommon based on a review of the existing literature. RCC are somewhat radioresistant and therefore, palliative surgery must be considered when treating patients with this metastatic disease.
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Affiliation(s)
- Juho Suojanen
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Esa Färkkilä
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Tessa Helkamaa
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Venla Loimu
- Department of Oncology, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Jyrki Törnwall
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Christian Lindqvist
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Jaana Hagström
- The Haartman Institute, Department of Pathology and HUSLAB, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Karri Mesimäki
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
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Abstract
Renal cell carcinoma represents 3% of all adult malignant tumors. It occurs more frequently in the fifth and sixth decade of life and in a male-female ratio of 1.5 : 1. Among all the primary tumors that arise below the level of the clavicle, renal cell carcinoma is the third most common neoplasm that metastasizes to the head and neck region, but rarely has it been described as the presenting symptom of this tumor. In 7.5% of the patients with renal cell carcinoma, head and neck metastasis is the presenting complaint. However, only 1% of the patients with renal cell carcinoma have metastases confined only to the head and neck; and a solitary cervical metastatic mass, as in the case of our patient, is rare.It seems that head and neck metastasis of renal cell carcinoma should preferentially be treated with surgical excision because of the associated morbidity and quality-of-life issues. Renal cell carcinoma should be considered in the differential diagnosis of any growing lesion in the head and neck.
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Affiliation(s)
- Mahmut Özkiriş
- Department of Otolaryngology, Head and Neck Surgery, Kayseri Tekden Hospital, Kayseri, Turkey
| | - Utku Kubilay
- Dr. Lütfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Ozan Seymen Sezen
- Dr. Lütfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
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Spyropoulou D, Vassiliou V, Tzelepi V, Kardari M, Tsamandas AC, Kardamakis D. Metastatic adenocarcinoma of parotid gland originating from the ampulla of vater: case report and review of the literature. J Gastrointest Cancer 2008; 38:95-8. [PMID: 19016351 DOI: 10.1007/s12029-008-9038-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2008] [Accepted: 07/01/2008] [Indexed: 10/21/2022]
Abstract
AIM To report a rare case of metastasis from an adenocarcinoma of the ampulla of Vater to the parotid gland. PATIENTS AND METHODS In February 2004, a 61-year-old male underwent Whipple surgery due to a grade II adenocarcinoma of the ampulla of Vater (stage IB:pT2N0M0). Post surgery, the patient did not receive any adjuvant treatment, but was followed up regularly. Two years post surgery, an abdominal computed tomography (CT) revealed metastatic hepatic lesions. The patient subsequently underwent three lines of chemotherapy without significant response. Two months after chemotherapy (April 2007), the patient complained of a painless lump in the parotid region that was progressing fast. Not long after presentation, the mass caused severe local pain that was hardly managed with opioid analgesics. A head and neck CT depicted a 5 x 4 x 3 cm solid mass that was infiltrating the masseter and pterygoid muscles, the mandible, and parotid gland. Fine needle aspiration showed that the infiltrating mass was due to an adenocarcinoma of the ampulla of Vater. The patient subsequently received palliative radiotherapy (50.4 Gy), achieving a considerable therapeutic response. CONCLUSIONS Metastasis of adenocarcinoma of the ampulla of Vater to the parotid gland has not to our knowledge been previously reported. Radiotherapy offers an excellent means of palliation with minimal morbidity.
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Affiliation(s)
- Despina Spyropoulou
- Department of Radiation Oncology, University of Patras Medical School, 265 00, Patras, Greece
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Mrena R, Leivo I, Passador-Santos F, Hagström J, Mäkitie AA. Histopathological findings in parotid gland metastases from renal cell carcinoma. Eur Arch Otorhinolaryngol 2008; 265:1005-9. [PMID: 18438681 DOI: 10.1007/s00405-008-0679-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Accepted: 04/08/2008] [Indexed: 11/25/2022]
Abstract
Metastatic tumours involving the parotid gland arising from non-head and neck origin are rare. Immunohistochemistry has improved the differential diagnosis of these lesions. Current immunohistochemical markers allow the distinction between a number of potential primary tumours (e.g., lung, kidney and breast). We present the clinical and histomorphological features of three renal cell carcinoma (RCC) patients presenting with a parotid mass, review the literature of various non-head and neck malignancies metastasizing to the parotid gland, and discuss their differential diagnosis. Two females and one male, aged 58 to 76 years, presented with a parotid tumour of renal cell origin. In one case, the parotid mass was the first clinical manifestation. In the two other cases, a nephrectomy had been performed 5-9 years earlier because of RCC. The cases showed a highly vascular parotid lesion causing difficulty in interpretation of the fine needle aspirate. Two patients underwent a superficial parotidectomy and one patient an open biopsy of the parotid gland tumour. Immunohistochemical stainings for vimentin, CD10 and PNRA were positive suggesting renal cell origin, which was later confirmed. Clinical and radiological evaluations and diagnosis by fine needle aspiration may prove difficult partly due to the vascular nature of parotid metastasis of renal cell carcinoma. Immunohistochemical staining is useful in identifying the primary tumour.
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Affiliation(s)
- Roderik Mrena
- Department of Otolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland
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Abstract
The parotid gland is an uncommon site of metastasis from carcinomas arising outside the head and neck region. Involvement of the parotid gland as an initial site of metastasis or presentation is rare. The present case report is the first, to our knowledge, to describe the management and outcome of an elderly man whose first presentation of an asymptomatic squamous cell carcinoma of the lung was that of a rapidly growing fungating left parotid mass.
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Affiliation(s)
- Martin F Borg
- Department of Radiation Oncology, Royal Adelaide Hospital, South Australia, Australia.
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Simo R, Sykes AJ, Hargreaves SP, Axon PR, Birzgalis AR, Slevin NJ, Farrington WT. Metastatic renal cell carcinoma to the nose and paranasal sinuses. Head Neck 2000; 22:722-7. [PMID: 11002329 DOI: 10.1002/1097-0347(200010)22:7<722::aid-hed13>3.0.co;2-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Renal cell carcinoma represents 3% of all malignant tumors. Metastatic deposits of renal cell carcinoma to the head and neck region are infrequent. The objective of this work is to analyze the clinical presentation, radiologic features, surgical and radiotherapy treatment, and outcome of metastatic renal cell carcinoma to the nose and sinuses. METHODS Retrospective review of 6 patients diagnosed with renal cell carcinoma who had nasal metastasis develop and were seen at the Christie Hospital in Manchester over the past 8 years. RESULTS Six patients with renal cell carcinoma were seen with recurrent epistaxis, nasal obstruction, and unpleasant nasal crusting. Three patients had orbital involvement. Examination under general anaesthesia and biopsy was performed in all 6 cases. Histologic studies confirmed metastases of renal cell carcinoma in all 6 patients. All patients underwent local external beam radiotherapy. The most common dose used was 35 Gy in 8 daily fractions. All patients had symptomatic control of local nasal disease with a minimum follow-up of 2 years in 4 patients. Two patients died within 6 months of the radiotherapy treatment as a result of their primary tumor. CONCLUSIONS Metastatic renal cell carcinoma to the nose and paranasal sinuses is rare but has unpleasant symptoms. Local symptomatic control with radiotherapy is excellent.
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Affiliation(s)
- R Simo
- University Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Lewisham, Lewisham High Street, London SE13 6LR, United Kingdom
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Sesenna E, Tullio A, Piazza P. Treatment of craniofacial metastasis of a renal adenocarcinoma: report of case and review of literature. J Oral Maxillofac Surg 1995; 53:187-93. [PMID: 7830186 DOI: 10.1016/0278-2391(95)90400-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- E Sesenna
- Department of Maxillo-Facial Surgery, Hospital of Parma, Italy
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Di Gello V, Saltutti C, Trippitelli A, Fiorelli C, Durval A, Villari D, Stefanucci S. Metastasi Linguale Da Adenocarcinoma Renale: Presentazione di un caso e Revisione Della Letteratura. Urologia 1986. [DOI: 10.1177/039156038605300630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | | | - A. Durval
- Clinica Chirurgica dell'Università di Pavia
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Eick JJ, Bell KA, Stephan MT, Fuselier HA. Metastatic renal cell carcinoma presenting as an intrasellar mass on computerized tomography. J Urol 1985; 134:128-30. [PMID: 4009805 DOI: 10.1016/s0022-5347(17)47023-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We report a case of renal cell carcinoma metastatic to the pituitary gland. A review of the literature indicated breast carcinoma to be the most frequent primary tumor metastatic to this site, while renal cell carcinoma metastasis has not been reported previously. This case emphasizes the capricious nature of renal cell carcinoma, particularly in a patient presenting with no evidence of disseminated disease.
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Ericsson M, Biörklund A, Cederquist E, Ingemansson S, Akerman M. Surgical treatment of metastatic disease in the thyroid gland. J Surg Oncol 1981; 17:15-23. [PMID: 7230827 DOI: 10.1002/jso.2930170104] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Metastatic disease in the thyroid gland is uncommon in clinical practice. Preoperative investigation with thyroid scan and fine-needle aspiration biopsy verified or strongly suggested metastatic disease in seven out of nine patients. All patients were treated by thyroid surgery. Three patients died within 4 months in disseminated disease. The remaining seven patients had a survival rate of between 1 and 5 years. Three patients are still alive 12, 29, and 48 months after thyroid surgery. Surgical treatment for metastatic disease in the thyroid, especially due to metastatic renal carcinoma and melanoma, is recommended.
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Abstract
A case of renal cell carcinoma presenting as a nosebleed of three-week duration is described. Light microscopy of a nasal lesion showed a richly vascular tumor, forming glands and uniformly consisting of clear cells. Cytochemically and ultrastructurally, the presence of abundant lipid droplets and glycogen within the neoplastic cells indicated a renal origin. An extended clinical search for a primary kidney tumor was undertaken in view of a negative intravenous tomographic pyelography and renal scan findings. An angiogram finally revealed an intrarenal mass which was proven pathologically as a renal cell carcinoma.
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13
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Abstract
A rare metastatic cancer in the soft tissues of the oral cavity has been discussed. The importance of a good clinical examination and the interrelationship between medicine and dentistry have been emphasized.
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