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Kamal Z, Singh C, Tandon S, Lamba AK, Urs AB, Rajoria S. Metastatic Sarcomatoid Renal Cell Carcinoma: A Journey From the Kidney to the Gingiva. Cureus 2024; 16:e63827. [PMID: 39100047 PMCID: PMC11297549 DOI: 10.7759/cureus.63827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2024] [Indexed: 08/06/2024] Open
Abstract
Oral metastatic lesions are very rare and are often diagnosed at a later stage, complicating treatment. Renal cell carcinoma (RCC) is the third most frequent neoplasm to metastasize to the oral cavity, following breast and lung cancers. These metastatic lesions are usually asynchronous and develop after the initial diagnosis, affecting the overall survival rate. This report describes a known case of RCC with a growth in the mandibular gingiva. Multiple pulmonary and femoral metastases appeared five years after the initial renal lesion. The gingival growth was excised and referred for histopathological examination, which revealed a pleomorphic sarcomatoid cellular morphology. Immunohistochemistry with an array of markers led to the diagnosis of sarcomatoid RCC, a rare high-grade tumor. This case underscores the importance of detailed history-taking, interpretation of clinical findings, and emphasis on histopathological examination to arrive at a conclusive diagnosis.
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Affiliation(s)
- Zainab Kamal
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Chandergupt Singh
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Shruti Tandon
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Arundeep K Lamba
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Aadithya B Urs
- Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Shivangni Rajoria
- Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, IND
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2
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Bruckmann M, Brenet E, Boulagnon-Rombi C, Louvrier A, Mauprivez C. Effectiveness of immune checkpoint inhibitors in the treatment of kidney cancer oral metastasis. A case report. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101913. [PMID: 38719194 DOI: 10.1016/j.jormas.2024.101913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/06/2024] [Indexed: 05/21/2024]
Abstract
Oral cavity metastasis from renal cell carcinoma is rare with poor prognosis. Recently immune checkpoint inhibitors (ICIs) have shown promising outcomes in the treatment of advanced RCC. Herein, we report a case of palatal lesion mimicking vascular tumor in a 60-year-old woman with locally advanced kidney cancer (T3aN0M0). She underwent an excisional biopsy, and histopathological examinations revealed an oral metastasis from clear cell renal cell carcinoma (ccRCC). The patient was treated with a combination of two ICIs with nivolumab, a programmed death 1 (PD-1), and ipilimumab, a cytotoxic T-lymphocyte-associated antigen 4 (CTLA4). After 3 cycles of systemic immunotherapy, the palate was completely well healed and after 13 months of follow-up, there was no evidence of recurrence. Regarding treatments, radical surgery is often recommended due to a high local control in case of solitary lesions or oligo-metastases. However, this option therapy is associated with a poor quality of life. To the best of our knowledge, this is the first case to suggest the benefits of ICIs in the treatment of oral metastases from ccRCC. Combining ICIs with conservative surgery could be another treatment option for oral metastasis in patients with renal cell carcinoma.
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Affiliation(s)
- M Bruckmann
- Service d'Oto-Rhino-Laryngologie, CHU de Reims, F-51100 Reims, France
| | - E Brenet
- Service d'Oto-Rhino-Laryngologie, CHU de Reims, Université de Reims Champagne-Ardenne, Laboratoire EA4691 (BIOS), F-51100 Reims, France
| | - C Boulagnon-Rombi
- Université de Reims Champagne-Ardenne, UMR CNRS 7369, CHU Reims, Laboratoire de Pathologie, F-51100, Reims, France
| | - A Louvrier
- CHU Besançon, Chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, Université de Franche-Comté, SINERGIES, F-25000 Besançon, France.
| | - C Mauprivez
- Service de Chirurgie Orale, Pôle de Médecine Bucco-Dentaire, CHU de Reims, Université de Reims Champagne-Ardenne, Laboratoire EA4691 (BIOS), F-51100 Reims, France
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3
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Priya M, Xavier J, John S, Angral S, Malhotra M, Bhardwaj A, Varshney S, Venkatesan S. Metastasis in Sinonasal Region Revealing a Silent Primary: A Series of 2 Cases with Review of Literature. Indian J Otolaryngol Head Neck Surg 2022; 74:1967-1972. [PMID: 36452680 PMCID: PMC9702466 DOI: 10.1007/s12070-020-01931-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022] Open
Abstract
Metastasis to the nasal cavity and paranasal sinuses are very rare and only few cases have been reported so far. Metastatic nasal mass with silent primary renal cell carcinoma (RCC) is even rarer. So are giant cell tumors which rarely affects soft tissues whether superficial or deep. These rarely occur in nasal cavity. We would like to discuss 2 cases-one being a 74 year old female with a solitary asymptomatic extensive metastatic lesion in sinonasal area of silent primary renal cell carcinoma and other being a 38 year old female multiple lytic expansile lesions in facial and skull bones who was previously treated for giant cell tumor of long bone-tibia. We aim to bring their occurrence to notice as they are rare, to highlight importance of these tumors in differential diagnosis of sinonasal masses and treatment options for the same.
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Affiliation(s)
- Madhu Priya
- Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
| | - Joyson Xavier
- Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
| | - Saumya John
- Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
| | - Sumeet Angral
- Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
| | - Manu Malhotra
- Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
| | - Abhishek Bhardwaj
- Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
| | - Saurabh Varshney
- Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
| | - Sneha Venkatesan
- Department of Otorhinolaryngology & Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
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4
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Silver JA, Almhanedi H, Lai JK, Tham AC, Ajise O, Tewfik MA. A Case of Unilateral Proptosis Secondary to Prostatic Metastasis. EAR, NOSE & THROAT JOURNAL 2022:1455613221119067. [PMID: 36007169 DOI: 10.1177/01455613221119067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Prostate cancer metastases involving the orbit and/or paranasal sinuses represent a rare oncological presentation. Patients can have a myriad of symptoms such as proptosis, periorbital swelling, blurry vision, rhinorrhea, epistaxis, anosmia, or others depending on the structures involved. The differential diagnosis of paranasal sinus masses on imaging studies is broad and can include inflammatory, congenital, or neoplastic masses; leading to the requirement of biopsy for definitive diagnosis. Tissue sample is usually obtained via an endoscopic approach. The prognosis of such a presentation is not well described in the literature, but it is usually guarded due to the advanced stage of the disease and generally a poorly differentiated primary tumor. Treatments usually aim to reduce the burden of disease and debulk the tumor mass for palliative purposes. We present a case of a 71-year-old male presenting with unilateral proptosis and periorbital swelling secondary to prostatic metastasis.
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Affiliation(s)
- Jennifer A Silver
- Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Hamad Almhanedi
- Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Jonathan K Lai
- Department of Anatomical Pathology, McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Alex C Tham
- Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, QC, Canada
- Department of Otolaryngology - Head and Neck Surgery, Tan Tock Seng Hospital, Singapore
| | - Oluyomi Ajise
- Department of Anatomical Pathology, McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Marc A Tewfik
- Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, QC, Canada
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5
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Ross T, Malik A, Awad Z. Oligometastatic renal cell carcinoma in the palatine tonsil: successful resection using trans-oral robotic surgery. BMJ Case Rep 2020; 13:13/12/e235768. [PMID: 33318261 PMCID: PMC7737078 DOI: 10.1136/bcr-2020-235768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
A man in his mid 70s was referred to head and neck outpatients with bulky tissue in the left tonsillar fossa. He had previously been treated for oligometastatic renal clear cell carcinoma (diagnosed over 15 years prior to disease recurrence) by tonsillectomy and adjuvant radiotherapy (years from primary treatment), followed by trans-oral laser surgery to his oropharyngeal recurrence 3 years later. Examination under anaesthetic and biopsy confirmed further recurrence of disease in the left tonsillar fossa, with parapharyngeal extension, which has not been previously reported in the literature. After discussion in the head and neck and urology multi-disciplinary teams meeting, the patient was offered trans-oral robotic-assisted surgery (TORS) for local control and prevention of progression of a fungating oropharyngeal mass. TORS partial pharyngectomy and left buccal artery myomucosal flap reconstruction were successfully carried out, with preservation of some swallow function.
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Affiliation(s)
- Talisa Ross
- Imperial College Healthcare NHS Trust, London, UK,Imperial College London Faculty of Medicine, London, UK
| | - Akshat Malik
- Imperial College Healthcare NHS Trust, London, UK
| | - Zaid Awad
- Imperial College Healthcare NHS Trust, London, UK,Imperial College London Faculty of Medicine, London, UK
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6
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Verma R, Gowda VN, Singh A, Priya M, Kishore S, Joshi PP. Epistaxis: the cause found beyond the nose. AUTOPSY AND CASE REPORTS 2020; 11:e2020207. [PMID: 34277483 PMCID: PMC8101650 DOI: 10.4322/acr.2020.207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/08/2020] [Indexed: 12/31/2022] Open
Abstract
Renal cell carcinoma (RCC) is a malignant disease that is often diagnosed at a metastatic stage. The head and neck represent up to 3% of the metastatic RCC, and the paranasal sinus area is one of the least involved sites. Here, we introduce the case of a 74-year-old female patient who presented with a history of traumatic nasal bleed. A cranial computed tomography scan and magnetic resonance imaging showed a fronto-ethmoidal mass with pachymeningeal involvement. A nasal biopsy from the paranasal sinuses was taken. On histopathological examination, metastatic clear cell carcinoma was the main hypothesis, which later was confirmed to be RCC on immunohistochemistry. On further radiological examination, an exophytic mass was depicted in the kidney's upper and middle pole. The patient had no renal complaints and was asymptomatic. Fronto-ethmoidal sinus is a rare site for metastatic RCC, especially in cases where the patient is asymptomatic. Early detection by keeping RCC metastasis as the differential diagnosis in such cases can lead to early treatment and improve the overall survival of the patient.
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Affiliation(s)
- Rahul Verma
- All Institute of Medical Science Rishikesh, Department of Pathology. Rishikesh, Uttarakhand, India
| | - Vinay Nagaraja Gowda
- All Institute of Medical Science Rishikesh, Department of Pathology. Rishikesh, Uttarakhand, India
| | - Ashok Singh
- All Institute of Medical Science Rishikesh, Department of Pathology. Rishikesh, Uttarakhand, India
| | - Madhu Priya
- All Institute of Medical Science Rishikesh, Department of Ear, Nose and Throat. Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- All Institute of Medical Science Rishikesh, Department of Pathology. Rishikesh, Uttarakhand, India
| | - Prashant Pranesh Joshi
- All Institute of Medical Science Rishikesh, Department of Pathology. Rishikesh, Uttarakhand, India
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7
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Mahuvakar AD, Nair D, Pai PS. Transnasal Endoscopic Resection of the Intraconal Metastases From Renal Cell Carcinoma: a Case Report and Review of Literature. Indian J Surg Oncol 2020; 11:318-322. [PMID: 33364728 DOI: 10.1007/s13193-020-01237-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/17/2020] [Indexed: 11/24/2022] Open
Abstract
Renal cell carcinoma (RCC) is the most common malignancy to cause metastasis to sinonasal cavity. These metastases can occasional cause invasion into the orbit. Isolated intraconal intraorbital metastasis from RCC is very rare. We hereby describe a case of 72-year-old female, who underwent right nephrectomy for RCC, 8 years back, and now presenting with a space occupying lesion in the right intraorbital intraconal compartment with no involvement of the paranasal sinuses. En bloc resection of the tumor was achieved via transnasal endoscopic approach. This is a rare case where minimally invasive surgery was done for metastatic lesion, with minimal postoperative morbidity.
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Affiliation(s)
- Ankit D Mahuvakar
- Department of Head Neck Surgical Oncology, Tata Memorial Hospital, HBNI University, Mumbai, India
| | - Deepa Nair
- Department of Head Neck Surgical Oncology, Tata Memorial Hospital, HBNI University, Mumbai, India
| | - Prathamesh S Pai
- Department of Head Neck Surgical Oncology, Tata Memorial Hospital, HBNI University, Mumbai, India
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8
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Ranjan SK, Mittal A, Kumar S, Mammen KJ, Navariya SC, Bhirud DP. Epistaxis presenting as sentinel feature of metastatic renal cell carcinoma: A case report and review of literature. J Family Med Prim Care 2020; 9:3766-3769. [PMID: 33102368 PMCID: PMC7567281 DOI: 10.4103/jfmpc.jfmpc_497_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/25/2020] [Accepted: 05/13/2020] [Indexed: 12/02/2022] Open
Abstract
About 30% of all newly diagnosed renal cell carcinoma (RCC) patients present with synchronous metastatic disease. Usual organs of involvement are lung (75%), soft tissues (36%), bone (20%), liver (18%), cutaneous sites (8%), and central nervous system (8%). Metastases to the paranasal sinuses (PNS) are relatively common and may be a part of synchronous multiorgan involvement or present in follow-up after radical nephrectomy (metachronous); but primary presentation as isolated paranasal mass before the diagnosis of RCC is extremely rare. Here, we report a case of 74-year-old female presented with epistaxis and nasal obstruction. On evaluation by magnetic resonance imaging (MRI), a heterogeneously enhancing mass was found involving left PNS. Biopsy from mass revealed clear cell RCC. Later on, contrast-enhanced computed tomography (CECT) of chest, abdomen, and pelvis showed enhancing mass from the upper pole of the left kidney with no evidence of metastasis elsewhere. The patient was started on pazopanib 800 mg once a day. At 6 months follow-up scan, there was a partial response at both primary as well as metastatic site.
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Affiliation(s)
| | - Ankur Mittal
- Department of Urology, AIIMS, Rishikesh, Uttarakhand, India
| | - Sunil Kumar
- Department of Urology, AIIMS, Rishikesh, Uttarakhand, India
| | - Kim J Mammen
- Department of Urology, AIIMS, Rishikesh, Uttarakhand, India
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9
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Carpenter K, Decater T, Iwanaga J, Maulucci CM, Bui CJ, Dumont AS, Tubbs RS. Revisiting the Vertebral Venous Plexus-A Comprehensive Review of the Literature. World Neurosurg 2020; 145:381-395. [PMID: 33049379 DOI: 10.1016/j.wneu.2020.10.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 12/23/2022]
Abstract
The venous drainage of the vertebral and paravertebral regions is important for a better understanding of hematogenous disease spread. Moreover, the spine surgeon must be well acquainted with this anatomy to minimize intraoperative and postoperative complications. A comprehensive review of the vertebral venous plexus (Batson plexus) was performed with a concentration on the clinical and surgical correlations of this venous network.
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Affiliation(s)
- Kennedy Carpenter
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
| | - Tess Decater
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Christopher M Maulucci
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - C J Bui
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA; Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies
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10
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Isolated Nasal Metastasis From Renal Cell Carcinoma 9 Years After Nephrectomy Seen on FDG PET. Clin Nucl Med 2020; 45:e110-e111. [PMID: 31714277 DOI: 10.1097/rlu.0000000000002836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 56-year-old man presented with intermittent epistaxis. Nasopharyngoscope revealed a hemorrhagic mass occupying the left nasal cavity. The patient had a history of renal clear cell carcinoma. F-FDG PET/CT was performed to evaluate the potential lesions systematically. PET/CT images showed low to moderate activity in the region of nasal cavity and paranasal sinuses. No abnormal uptake of F-FDG was observed in the rest of the body. Eventually, the mass was pathologically proved to be metastatic renal clear cell carcinoma.
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11
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The Specific Magnetic Resonance Imaging Indicators in Predicting Clear-Cell Renal Cell Carcinoma Metastatic to the Sinonasal Region. J Comput Assist Tomogr 2020; 44:70-74. [PMID: 31939885 DOI: 10.1097/rct.0000000000000948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to determine the valuable magnetic resonance imaging (MRI) features of sinonasal metastatic clear-cell renal cell carcinoma (cc-RCC), especially focusing on its dynamic-enhanced characteristics. METHODS The conventional and dynamic-enhanced MRI findings of 8 patients with histopathologically confirmed sinonasal metastatic cc-RCC were reviewed by 2 radiologists. The control group of 8 patients with capillary hemangioma underwent the same MRI protocol. RESULTS Metastatic cc-RCCs arose from the nasoethmoid region, maxillary sinus, posterior ethmoid and sphenoid sinus, and nasal cavity in 2 patients in each. These lesions were well circumscribed and the mean maximum dimension was 42 mm. The signal intensity of these lesions was isointense to brain stem on both MR T1- and T2-weighted images. All metastatic tumors showed vivid enhancement on enhanced T1-weighted image. Multiple flow voids within these metastatic lesions were identified in 6 patients. Peripheral cyst was detected around the metastatic tumor in 4 patients. Metastatic cc-RCCs exhibited a characteristic type 4 time intensity curve (TIC) similar to that of the internal carotid artery, whereas capillary hemangiomas showed a type 3 TIC on dynamic-enhanced MRI. CONCLUSIONS A hypervascular mass with the characteristic type 4 TIC in the sinonasal region is highly suggestive of a metastatic cc-RCC.
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12
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Dalakoti P, Pujary K, Ramaswamy B. Sinonasal Metastatic Renal Cell Carcinoma: A Report of Two Cases with Varied Presentation and a Review of Literature. Indian J Otolaryngol Head Neck Surg 2019; 71:2072-2077. [PMID: 31763296 PMCID: PMC6848442 DOI: 10.1007/s12070-018-1475-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/17/2018] [Indexed: 11/30/2022] Open
Abstract
Renal cell carcinoma is usually slow growing with delayed vague symptoms and may not be detected until an advanced stage. In only 9% of the cases the classical triad of "haematuria, costovertebral pain and abdominal mass" is seen. Less commonly, sinonasal metastasis may also be the presenting feature of RCC. So, in any case of sinonasal mass, possibility of metastasis from renal malignancy should be considered. Sinonasal metastasis from renal malignancy can occur even several years after the primary is treated with nephrectomy. In sinonasal region maxillary sinus is the most commonly affected. Isolated metastasis to the nose is extremely rare. Malignancies from various other sites of the body can also metastasize to sinonasal region. Epistaxis is the most common symptom. This is because of vascular stroma of the metastatic deposit. A 45 year old male with history of right nephrectomy 1 year back presented with intractable epistaxis. A 66 year old male presented with profuse epistaxis without any history of previous malignancies. Both the cases were evaluated resulting to the diagnosis of sinonasal metastasis from Renal Cell carcinoma. In the first case, metastasis occurred 1 year post surgery whereas in second case sinonasal metastasis was the presenting feature of Renal Cell carcinoma. Epistaxis is the most common symptom. This is because of vascular stroma of this metastatic deposit. In renal cancer, symptoms of metastasis often precede the symptoms of primary tumor.
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Affiliation(s)
- Pooja Dalakoti
- Department of Otolaryngology – Head and Neck Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Kailesh Pujary
- Department of Otolaryngology – Head and Neck Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Balakrishnan Ramaswamy
- Department of Otolaryngology – Head and Neck Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
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13
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Maxillary Sinus Mass as First Presentation of Silent Metastatic Renal Cell Carcinoma. J Craniofac Surg 2019; 30:e135-e137. [PMID: 30531280 DOI: 10.1097/scs.0000000000005036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Renal cell carcinoma accounts for more than 3% of all malignant diseases. Metastatic disease to the head and neck ranges from 15% to 30%. The 5-year survival rate after nephrectomy is 60% to 75%, but with multiorgan metastases the 5-year survival rate is significantly lower, 0% to 7%. The authors present the case of a patient with a progressive, painless right facial swelling over the maxillary area of 3-month's duration associated with a considerable decrease of right visual acuity. Cranial computed tomography scan and magnetic resonance imaging showed a maxillary sinus mass extending to the orbital cavity and 2 choroidal and retinal thickenings. The mass biopsy was performed by Caldwell-Luc procedure and pathology report suggested metastatic renal cell carcinoma. Following histological findings, a total body computed tomography scan showed a heterogeneous mass at the middle-lower portion of the right kidney measuring approximately 8 × 12 × 4 cm with associated ipsilateral renal vein thrombosis. The patient was referred to the Oncology Department for further treatment. Unfortunately, 3 months after the mass biopsy, the patient died due to complications of multiorgan failure. Although metastases of renal cell carcinoma to the head and neck are very rare, it should be first suspected when investigating a metastatic tumor in this region.
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14
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Gioia E, Carta F, Mariani C, Gerosa C, Puxeddu R. Unusual metastasis of papillary renal cell carcinoma to the pyriform sinus: Case report. Clin Case Rep 2019; 7:1222-1225. [PMID: 31183098 PMCID: PMC6552976 DOI: 10.1002/ccr3.2162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/27/2019] [Accepted: 03/31/2019] [Indexed: 12/19/2022] Open
Abstract
Renal cell carcinoma is the third most common cause of distant metastasis to the head and neck. Renal cell carcinoma metastasis should be considered in differential diagnosis when patients with a clinical history of renal cell carcinoma show a head and neck mass.
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Affiliation(s)
- Edoardo Gioia
- Unit of Otorhinolaryngology, Department of SurgeryAzienda Ospedaliero‐Universitaria di Cagliari, University of CagliariCagliariItaly
| | - Filippo Carta
- Unit of Otorhinolaryngology, Department of SurgeryAzienda Ospedaliero‐Universitaria di Cagliari, University of CagliariCagliariItaly
| | - Cinzia Mariani
- Unit of Otorhinolaryngology, Department of SurgeryAzienda Ospedaliero‐Universitaria di Cagliari, University of CagliariCagliariItaly
| | - Clara Gerosa
- Unit of Pathology, Department of SurgeryAzienda Ospedaliero‐Universitaria di Cagliari, University of CagliariCagliariItaly
| | - Roberto Puxeddu
- Unit of Otorhinolaryngology, Department of SurgeryAzienda Ospedaliero‐Universitaria di Cagliari, University of CagliariCagliariItaly
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15
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Chang MH, Kuo YJ, Ho CY, Kuan EC, Lan MY. Metastatic Tumors of the Sinonasal Cavity: A 15-Year Review of 17 Cases. J Clin Med 2019; 8:jcm8040539. [PMID: 31010194 PMCID: PMC6517969 DOI: 10.3390/jcm8040539] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/22/2019] [Accepted: 04/16/2019] [Indexed: 12/13/2022] Open
Abstract
Extranasal cancers that metastasize to the sinonasal cavity are very rare. To date, there are only limited reports regarding this rare condition within the literature. Therefore, we retrospectively reviewed all patients diagnosed with metastatic cancer of the sinonasal tract from 2003 to 2018 at a tertiary academic medical center. Patient demographic data, clinical presentation, treatment modalities, and outcomes were investigated. There were a total of 17 patients (9 males and 8 females) included in the analysis. The mean age was 56.8 years (range 27–80). The most common primary malignancies were hepatocellular carcinoma (n = 3) and gastrointestinal tract adenocarcinoma (n = 3). The most common site of metastasis was the nasal cavity (n = 8). Five patients received radical tumor resection and the others underwent radiotherapy, chemotherapy, or combined chemoradiotherapy. The 2-year survival was 28%. In summary, metastasis to the sinonasal cavity remains extremely rare. A high degree of suspicion regarding the possibility of metastatic spread to the sinonasal region is necessary for patients with a previous history of malignancy who present with new sinonasal symptoms. The treatment strategy of sinonasal metastatic cancer is usually palliative therapy and the prognosis remains poor. However, early detection and diagnosis, coupled with aggressive treatment, may improve patient quality of life.
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Affiliation(s)
- Miao-Hsu Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
| | - Ying-Ju Kuo
- Department of Pathology, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.
| | - Ching-Yin Ho
- School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.
- Department of Otolaryngology, Cheng Hsin Hospital, Taipei 11220, Taiwan.
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA 92868, USA.
| | - Ming-Ying Lan
- Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
- School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.
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16
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Bastier PL, Dunion D, de Bonnecaze G, Serrano E, de Gabory L. Renal cell carcinoma metastatic to the sinonasal cavity: A review and report of 8 cases. EAR, NOSE & THROAT JOURNAL 2019; 97:E6-E12. [PMID: 30273434 DOI: 10.1177/014556131809700902] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Renal cell carcinoma (RCC) metastatic in the sinonasal cavity is rare. In many cases, it represents the initial presentation of RCC. We conducted a retrospective chart review to report the clinical presentation, imaging, and treatment of RCC metastases in the sinonasal cavity at two tertiary care referral centers. Our population was made up of 8 patients-6 men and 2 women, aged 55 to 86 years (mean: 66.9; median: 63.5)-who had been diagnosed with cancer in the sinonasal cavity. The most common complaints were epistaxis, nasal obstruction, and diplopia. Cancers were located in the ethmoid sinus (n = 3), nasal cavity (n = 2), sphenoid sinus (n = 2), and maxillary sinus (n = 1). Local treatment involved resection and adjuvant radiotherapy in 4 patients, surgery alone in 2 patients, and radiotherapy alone in the other 2. The lesion was embolized before surgery in 4 cases. We also performed a critical review of similar published cases. Our literature review covered 53 cases of RCC metastatic to the sinonasal cavity, including ours. Metastases were the first presentation of RCC in 24 of these cases (45.3%); in our series, the metastases led to the diagnosis of the primary RCC in 3 cases (37.5%). In the 53 reported cases, metastatic resection was performed on 35 patients (66.0%). Survival data were available for 22 of these operated patients, and 17 of them achieved a complete local response. Adjunctive radiotherapy was not associated with a better local response. Overall survival was significantly better in patients who had an isolated metastasis rather than multiple metastases (p = 0.013). There was no difference in overall survival between patients whose metastasis represented the initial presentation of RCC and those whose metastasis did not (p = 0.95). We recommend that sinonasal metastasis be suspected in the event of unilateral nasal bleeding or nasal obstruction in patients diagnosed with RCC. Embolization may prevent abundant bleeding during removal. Surgery may improve the quality of life of these patients while decreasing nasal obstruction and bleeding.
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Affiliation(s)
- Pierre-Louis Bastier
- Department of Otorhinolaryngology-Head and Neck Surgery, Bordeaux University Hospital, Place Amélie Raba-Leon, 33000 Bordeaux, France.
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17
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Şahin B, Doruk C, Çelik M, Öztürk E, Güneş S, Kıyak ÖE. Atypical Metastasis to the Head and Neck Region: An Analysis of 11 Patients. Turk Arch Otorhinolaryngol 2018; 56:210-216. [PMID: 30701116 DOI: 10.5152/tao.2018.3633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 09/04/2018] [Indexed: 01/22/2023] Open
Abstract
Objective We present 11 patients with distant metastases to the head and neck from an infraclavicularly located primary tumor and discuss the management strategies including the clinical presentation, treatment modalities, and prognosis. Methods The retrospective data of the pathology reports and operation notes of 1239 patients who had undergone any kind of oncological surgical intervention between 2005 and 2017 were analyzed. All of the 11 patients included in the study were evaluated in our department's tumor board, and all patients with an operable lesion had undergone surgery. Inoperable patients were treated with chemotherapy and/or radiotherapy. Results The average age of the patients was 64.3 (48-88) years. Primary tumors were located in the lung (2), breast (2), ovary (2), prostate (2), kidney (1), and colon (1) and the primary lesion could not be determined in one patient. The most common symptom was newly occurred painless swelling (9/11, 81.8%) at the metastatic site. Four patients without any other distant metastases were operated. Of these four patients, two died during follow-up due to systemic disease, and the other two are alive and disease-free. Three of the seven inoperable patients were treated with chemotherapy and the other four with radiotherapy. The prognosis of this group was worse. Conclusion Although metastasis to the head and neck is not common, it is vital to keep in mind while approaching a patient with a lesion at the head and neck region especially if there is a history of lung, breast, and genitourinary cancers. Despite the poor prognosis, diminishing the tumor burden would increase the treatment success.
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Affiliation(s)
- Bayram Şahin
- Department of Otorhinolaryngology, Health Sciences University, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Can Doruk
- Department of Otorhinolaryngology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Mehmet Çelik
- Department of Otorhinolaryngology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Erkan Öztürk
- Department of Otorhinolaryngology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Selçuk Güneş
- Department of Otorhinolaryngology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Ökkeş Erkan Kıyak
- Department of Otorhinolaryngology, İstanbul University School of Medicine, İstanbul, Turkey
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Metastases to Both Parotid Glands Six and Twelve Years after Resection of Renal Cell Carcinoma. Case Rep Med 2018; 2018:7301727. [PMID: 29560015 PMCID: PMC5835304 DOI: 10.1155/2018/7301727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 12/09/2017] [Accepted: 01/01/2018] [Indexed: 11/17/2022] Open
Abstract
Metastases of renal cell carcinoma (RCC) involving the parotid gland are very rare. We present to our knowledge the first case of a 74-year-old woman with metastases of an RCC which affected both parotid glands six and twelve years following curative therapy.
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Aslıer M, Ecevit MC. Metastatic Renal Cell Carcinoma of the Nasal Septum: A Case Report. Turk Arch Otorhinolaryngol 2018; 56:51-53. [PMID: 29988298 DOI: 10.5152/tao.2018.2826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 11/03/2017] [Indexed: 11/22/2022] Open
Abstract
Metastatic lesions of the nasal cavity and paranasal sinuses are rare tumors. Carcinomas originating from intrapelvic organs play an important role in the differential diagnosis of these masses because of their paradoxic spread to the head and neck region. In this study we report a case with metastatic renal cell carcinoma of the caudal nasal septum.
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Affiliation(s)
- Mustafa Aslıer
- Department of Otorhinolaryngology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Mustafa Cenk Ecevit
- Department of Otorhinolaryngology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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20
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Badri M, Gader G, Bahri K, Zammel I. Skull metastasis revealing a renal tumor: A case report and review of the literature. Int J Surg Case Rep 2018; 43:56-60. [PMID: 29453166 PMCID: PMC5849813 DOI: 10.1016/j.ijscr.2018.01.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/16/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Renal cell carcinomas represent 85% of malignant renal tumors. Typically, the tumor remains asymptomatic a long time before the appearance of urologic clinical signs. In some cases, metastasis can precede the manifestations of the primary tumor. Different sites are potential metastatic localizations for renal tumors, including skull metastases who represent a very rare location. CASE DESCRIPTION We report the case of a 65-year-old man presented after the appearance of a skull mass. This tumefaction developed and had progressively grown up during 9 months. Neurological examination was normal. Brain imaging showed a soft tissue lesion in the left parietal bone with marked osteolysis. Peroperative was found a huge oval-shape hemorrhagic and firm mass associated with scalp invasion and bone destruction that was totally resected. Histopathology revealed renal cell carcinoma (RCC). Pelvic and abdominal CT scan was performed, revealing a large mass on the left kidney with irregular contours and poor definition. The patient was then transferred to urology where he underwent nephrectomy. The patient went then through adjuvant chemotherapy. Clinical and radiological follow up of 12 months did not bring to light tumor recurrence. CONCLUSIONS Although metastases to the head and neck occur infrequently, they should be considered when evaluating any unusual subcutaneous mass in the head and neck. RCC should not be discounted when sites as unlikely as the calvaria are evaluated. Treatment of metastatic renal cell carcinoma is complex, and the optimal regimen for achieving a lasting response without severe toxicity has not yet been defined.
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Affiliation(s)
- Mohamed Badri
- El Manar-Tunis University, Faculty of medicine of Tunis, Burns and Trauma Center, Department of Neurosurgery, Ben Arous, Tunisia.
| | - Ghassen Gader
- El Manar-Tunis University, Faculty of medicine of Tunis, Burns and Trauma Center, Department of Neurosurgery, Ben Arous, Tunisia.
| | - Kamel Bahri
- El Manar-Tunis University, Faculty of medicine of Tunis, Burns and Trauma Center, Department of Neurosurgery, Ben Arous, Tunisia.
| | - Ihsen Zammel
- El Manar-Tunis University, Faculty of medicine of Tunis, Burns and Trauma Center, Department of Neurosurgery, Ben Arous, Tunisia.
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21
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Wong EHC, Tetter N, Glatz K, Brand Y. Renal cell carcinoma metastases to the maxillary sinus. BMJ Case Rep 2017; 2017:bcr-2017-220876. [PMID: 29054909 DOI: 10.1136/bcr-2017-220876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Metastasis of renal cell carcinoma (RCC) to the head and neck region is rare. We report the case of a 65-year-old man with history of RCC, presented 7 years after nephrectomy, adrenalectomy and lung metastasectomy for his primary tumour, with symptoms of nasal obstruction, postnasal drip, productive cough and pressure sensation in the left maxillary sinus. CT revealed a unilateral, irregular opacification in the left maxillary sinus with bony erosion of the infraorbital canal wall. A yellow cystic lesion was completely removed from the maxillary sinus during functional endoscopic sinus surgery and histopathological analysis confirmed the diagnosis of a metastatic RCC. Patient continued to be managed with his pre-existing treatment for advanced RCC.
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Affiliation(s)
- Eugene Hung Chih Wong
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Basel, Basel, Switzerland
| | - Nora Tetter
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Basel, Basel, Switzerland
| | - Katharina Glatz
- Institute of Pathology, Universitatsspital Basel, Basel, Switzerland
| | - Yves Brand
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Basel, Basel, Switzerland
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22
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Haymes A, Mahalingam S, Choudhury N. Small cell lung cancer presenting as unilateral rhinorrhoea. BMJ Case Rep 2017; 2017:bcr-2017-219527. [PMID: 28775084 DOI: 10.1136/bcr-2017-219527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The metastatic spread of infraclavicular malignancies to the nasal cavity is rare. We describe the case of a 58-year-old man who presented with a 4-month history of right-sided rhinorrhoea, maxillary hypoesthesia, hyposmia and hypogeusia. Clinical examination revealed an irregular mass within the right nasal cavity. Immunohistochemical analyses of biopsies were consistent with small cell carcinoma of indeterminate origin. A positron emission tomography scan demonstrated extensive mediastinal lymphadenopathy with collapse-consolidation of the right lung's middle lobe and no other sites of metastasis. Following discussion at the lung multidisciplinary team meeting, a diagnosis of metastatic small cell lung cancer (SCLC) was made; the patient was staged with N3, M1b disease and palliative chemo-radiotherapy was started. To the best of our knowledge, this report represents the first documented case of a solitary nasal cavity metastasis arising from a SCLC.
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Affiliation(s)
- Adam Haymes
- Department of ENT, East Surrey Hospital, Redhill, Surrey, UK
| | - Sridhayan Mahalingam
- Department of ENT, Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, Kent, UK
| | - Natasha Choudhury
- Department of ENT, Surrey and Sussex Healthcare NHS Trust, Redhill, Surrey, UK
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23
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Metastatic Renal Cell Carcinoma Presenting as a Paranasal Sinus Mass: The Importance of Differential Diagnosis. Case Rep Otolaryngol 2017; 2017:9242374. [PMID: 28168075 PMCID: PMC5266817 DOI: 10.1155/2017/9242374] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 11/15/2016] [Accepted: 12/14/2016] [Indexed: 11/18/2022] Open
Abstract
Metastases in the paranasal sinuses are rare; renal cell carcinoma is the most common cancer that metastasizes to this region. We present the case of a patient with a 4-month history of a rapidly growing mass of the nasal pyramid following a nasal trauma, associated with spontaneous epistaxis and multiple episodes of hematuria. Cranial CT scan and MRI showed an ethmoid mass extending to the choanal region, the right orbit, and the right frontal sinus with an initial intracranial extension. Patient underwent surgery with a trans-sinusal frontal approach using a bicoronal incision combined with an anterior midfacial degloving; histological exam was compatible with a metastasis of clear cell renal cell carcinoma. Following histological findings, a total body CT scan showed a solitary 6 cm mass in the upper posterior pole of the left kidney identified as the primary tumor. Although rare, metastatic renal cell carcinoma should always be suspected in patients with nasal or paranasal masses, especially if associated with symptoms suggestive of a systemic involvement such as hematuria. A correct early-stage diagnosis of metastatic RCC can considerably improve survival rate in these patients; preoperative differential diagnosis with contrast-enhanced imaging is fundamental for the correct treatment and follow-up strategy.
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24
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Affiliation(s)
- E T Cheng
- Division of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California 94305-5328, USA
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25
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Erkan S, Somner J, Rajan GP. Sunitinib as Neoadjuvant Chemotherapy in the Management of Metastatic Renal Cell Carcinoma Mimicking a Glomus Vagale Tumor in the Head and Neck: A Case Report and Review of Literature. J Neurol Surg Rep 2016; 77:e77-82. [PMID: 27247912 PMCID: PMC4882188 DOI: 10.1055/s-0036-1579629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background Metastatic renal cell carcinoma (RCC) of the head and neck with intracranial extension is rare and may pose difficulties to the diagnosis and management. Method We describe a unique case of a 76-year-old man with a metastatic RCC to the neck and lateral skull base with intracranial extension presenting with Collet-Sicard syndrome 8 years after initial diagnosis. The radiologic features were consistent with the diagnosis of a glomus vagale tumor on the basis of clinical and radiologic features. Results Despite radiotherapy, the intracranial extension progressed in size, resulting in early hydrocephalus. Sunitinib, a novel tyrosine kinase inhibitor, was instituted to treat the glomus vagale tumor with a marked reduction in tumor volume and resolution of the early hydrocephalus. The surgical resection of the tumor with its intracranial extension was achieved without additional postoperative morbidity. The histopathologic diagnosis surprisingly demonstrated metastatic RCC. Conclusion We present a case of metastatic RCC to the head and neck region mimicking a glomus vagale tumor and describe the first use of sunitinib as a neoadjuvant chemotherapy to achieve a single-stage radical en bloc resection of the tumor mass.
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Affiliation(s)
- Serkan Erkan
- Department of Otolaryngology, Head and Neck Surgery, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Jessica Somner
- Department of Otolaryngology, Head and Neck Surgery, University of Western Australia, Nedlands, Western Australia, Australia
| | - Gunesh P Rajan
- Department of Otolaryngology, Head and Neck Surgery, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Department of Otolaryngology, Head and Neck Surgery, School of Surgery, University of Western Australia, Murdoch, Western Australia, Australia
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26
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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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27
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López F, Rodrigo JP, Silver CE, Haigentz M, Bishop JA, Strojan P, Hartl DM, Bradley PJ, Mendenhall WM, Suárez C, Takes RP, Hamoir M, Robbins KT, Shaha AR, Werner JA, Rinaldo A, Ferlito A. Cervical lymph node metastases from remote primary tumor sites. Head Neck 2015; 38 Suppl 1:E2374-85. [PMID: 26713674 DOI: 10.1002/hed.24344] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 09/14/2015] [Accepted: 10/17/2015] [Indexed: 11/08/2022] Open
Abstract
Although most malignant lymphadenopathy in the neck represent lymphomas or metastases from head and neck primary tumors, occasionally, metastatic disease from remote, usually infraclavicular, sites presents as cervical lymphadenopathy with or without an obvious primary tumor. In general, these tumors metastasize to supraclavicular lymph nodes, but occasionally may present at an isolated higher neck level. A search for the primary tumor includes information gained by histology, immunohistochemistry, and evaluation of molecular markers that may be unique to the primary tumor site. In addition, 18F-fluoro-2-deoxyglocose positron emission tomography combined with CT (FDG-PET/CT) has greatly improved the ability to detect the location of an unknown primary tumor, particularly when in a remote location. Although cervical metastatic disease from a remote primary site is often incurable, there are situations in which meaningful survival can be achieved with appropriate local treatment. Management is quite complex and requires a truly multidisciplinary approach. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2374-E2385, 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
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,University of Oviedo, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Carl E Silver
- Departments of Surgery and Otolaryngology, Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Missak Haigentz
- Departments of Medicine (Oncology) and Otorhinolaryngology-Head & Neck Surgery, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Justin A Bishop
- Departments of Pathology, The Johns Hopkins University, Baltimore, Maryland
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Dana M Hartl
- Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France.,Laboratoire de Phonétique et de Phonologie, Sorbonne Nouvelle, Paris, France
| | - Patrick J Bradley
- Department of Otolaryngology-Head and Neck Surgery, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, United Kingdom
| | | | - Carlos Suárez
- University of Oviedo, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Marc Hamoir
- Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital and Cancer Center, Brussels, Belgium
| | - K Thomas Robbins
- Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Ashok R Shaha
- Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Jochen A Werner
- Department of Otolaryngology, Head and Neck Surgery, Marburg, Germany
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
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28
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Jatti D, Puri G, Aravinda K, Dheer DS. An Atypical Metastasis of Renal Clear Cell Carcinoma to the Upper Lip: A Case Report. J Oral Maxillofac Surg 2015; 73:371.e1-6. [DOI: 10.1016/j.joms.2014.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 09/14/2014] [Accepted: 09/16/2014] [Indexed: 02/06/2023]
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29
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D’Angelo T, Blandino A, Ascenti G, Vinci S, Gaeta M, Mazziotti S. Solitary metastasis of renal cell carcinoma in infratemporal fossa. Clin Imaging 2015; 39:155-7. [DOI: 10.1016/j.clinimag.2014.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 07/21/2014] [Accepted: 07/28/2014] [Indexed: 12/31/2022]
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30
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Marcotullio D, Iannella G, Macri GF, Marinelli C, Zelli M, Magliulo G. Renal clear cell carcinoma and tonsil metastasis. Case Rep Otolaryngol 2013; 2013:315157. [PMID: 24455373 PMCID: PMC3877590 DOI: 10.1155/2013/315157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 11/26/2013] [Indexed: 11/17/2022] Open
Abstract
Renal cell carcinoma is the most common renal tumor in adults. Clear cell carcinoma represents 85% of all histological subtypes. In February 2012 a 72-year-old woman came to our department due to the appearance of massive hemoptysis and pharyngodinia. Previously, this patient was diagnosed with a renal cell carcinoma treated with left nephrectomy. We observed an exophytic, grayish, and ulcerated mass in the left tonsillar lodge and decided to subject the patient to an immediate tonsillectomy. Postoperative histology showed nests of cells with highly hyperchromatic nuclei and clear cytoplasm. These features enabled us to make the diagnosis of renal clear cell carcinoma metastasis. Only few authors described metastasis of renal cell carcinoma in this specific site.
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Affiliation(s)
- Dario Marcotullio
- Organi di Senso Department, Sapienza University of Rome, 00165 Rome, Italy
| | | | - Gian Franco Macri
- Organi di Senso Department, Sapienza University of Rome, 00165 Rome, Italy
| | - Caterina Marinelli
- Organi di Senso Department, Sapienza University of Rome, 00165 Rome, Italy
| | - Melissa Zelli
- Otolaryngology Department, University of L' Aquila, Italy
| | - Giuseppe Magliulo
- Organi di Senso Department, Sapienza University of Rome, 00165 Rome, Italy
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31
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Metastatic renal cell carcinoma of the posterior nasal septum as the first presentation 10 years after nephrectomy. J Oral Maxillofac Surg 2013; 71:1813.e1-7. [PMID: 24040953 DOI: 10.1016/j.joms.2013.06.200] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 06/08/2013] [Accepted: 06/14/2013] [Indexed: 11/21/2022]
Abstract
Metastasis of renal cell carcinoma (RCC) to the head and neck region is infrequent, and metastatic RCC in the nasal cavity and paranasal sinuses is rare. Although there are reported cases of RCC to the paranasal sinuses, isolated metastasis of RCC to the nasal septum is extremely rare. This report describes a case of metastatic RCC of the posterior nasal septum that presented as severe epistaxis in a patient who underwent nephrectomy for RCC 10 years previously.
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Servato J, de Paulo L, de Faria P, Cardoso S, Loyola A. Metastatic tumours to the head and neck: retrospective analysis from a Brazilian tertiary referral centre. Int J Oral Maxillofac Surg 2013; 42:1391-6. [DOI: 10.1016/j.ijom.2013.05.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 05/22/2013] [Accepted: 05/29/2013] [Indexed: 11/30/2022]
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Anzalone CL, Cohen PR, Migden MR, Tannir NM. Mohs surgery in metastatic cancer: renal cell carcinoma solitary cutaneous metastasis and visceral tumor metastases to skin treated with microscopically controlled surgical excision. Int J Dermatol 2013; 52:856-61. [PMID: 23675612 DOI: 10.1111/ijd.12021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mohs micrographic surgery is the reference standard treatment for primary cutaneous malignancies. OBJECTIVES The purpose of this case study is to demonstrate that Mohs surgery may be considered as a possible treatment for a solitary metastatic tumor under the appropriate circumstances. METHODS We report a patient in whom a solitary cutaneous metastasis of renal cell carcinoma (RCC) was successfully treated with microscopically controlled surgical excision, and cite instances of the successful management of cutaneous metastases using the Mohs surgical technique in oncology patients reported in the literature. Patient reports and previous reviews of the subject were critically assessed. Salient features are presented. RESULTS Metastases to the skin are rare in RCC. Albeit rarely, surgical excision, particularly Mohs micrographic surgery, has been used for the removal of isolated RCC cutaneous metastases. In the present patient with metastatic RCC, a solitary cutaneous metastasis on the occipital scalp was successfully treated with Mohs micrographic surgery. There was no recurrence of the lesion after two years of follow-up; however, the patient eventually succumbed to progressive disease. CONCLUSIONS We suggest that, in the appropriate setting, surgical excision of isolated cutaneous metastases using microscopically controlled margins at the time of surgery should be added to the indications for Mohs surgery.
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Remenschneider AK, Sadow PM, Lin DT, Gray ST. Metastatic renal cell carcinoma to the sinonasal cavity: a case series. J Neurol Surg Rep 2013; 74:67-72. [PMID: 24294563 PMCID: PMC3836888 DOI: 10.1055/s-0033-1346972] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 03/10/2013] [Indexed: 12/16/2022] Open
Abstract
Objectives To describe the presentation, work-up, and management of patients with metastatic renal cell carcinoma (RCC) to the sinonasal cavity and skull base, and to describe our current treatment algorithm of endoscopic surgical resection followed by radiation therapy. Design Retrospective review of two recent cases from our institution over a 1-year period, with a relevant review of the literature. Setting A large regional tertiary care facility. Participants Consecutive cases of RCC with metastases to the sinonasal cavity presenting to our institution. Main Outcome Measures Preoperative and postoperative sinonasal outcome test (SNOT)-22 scores, duration of hospital stay, complications, and local disease control Results Patients in this series underwent preoperative embolization followed by endoscopic resection without complication. Postoperatively they were treated with radiation therapy. They experienced improvement in their SNOT-22 scores and are currently free of local disease. Conclusion Metastatic RCC to the sinonasal cavity can be safely treated with preoperative embolization followed by endoscopic surgical resection and radiation therapy, which can result in improvement in sinonasal quality of life and is a potential adjunct for local control of disease.
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Affiliation(s)
- Aaron K Remenschneider
- Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
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Choong CV, Tang T, Chay WY, Goh C, Tay MH, Zam NAM, Tan PH, Tan MH. Nasal metastases from renal cell carcinoma are associated with Memorial Sloan-Kettering Cancer Center poor-prognosis classification. CHINESE JOURNAL OF CANCER 2012; 30:144-8. [PMID: 21272447 PMCID: PMC4013344 DOI: 10.5732/cjc.010.10302] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Unusual sites of metastases are recognized in patients with renal cell carcinoma (RCC). However, the prognostic implications of these sites are not well understood. We used the Memorial Sloan-Kettering Cancer Center (MSKCC) risk classification for metastatic RCC to evaluate 912 consecutive patients with RCC managed at the Singapore General Hospital between 1990 and 2009. Among these patients, 301 had metastases either at diagnosis or during the course of illness. Nasal metastases, all arising from clear cell RCC, were identified histologically in 4 patients (1.3% of those with metastasis). All 4 patients were classified as MSKCC poor prognosis by current risk criteria. Nasal metastases were significantly associated with lung and bone metastases. The frequency of nasal metastases in patients with metastatic RCC is about 1 %, occurring predominantly in patients with clear cell RCC. Nasal metastases are associated with poor prognosis as estimated by the MSKCC risk classification, with attendant implications for selection of targeted therapy, and are usually associated with multi -organ dissemination, including concurrent lung and bone involvement.
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Affiliation(s)
- Caroline Victoria Choong
- Department of Medical Oncology, National Cancer Centre, Singapore, Singapore 169610, Republic of Singapore
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Evgeniou E, Menon KR, Jones GL, Whittet H, Williams W. Renal cell carcinoma metastasis to the paranasal sinuses and orbit. BMJ Case Rep 2012; 2012:bcr.01.2012.5492. [PMID: 22605794 DOI: 10.1136/bcr.01.2012.5492] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
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.
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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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Morvan JB, Veyrières JB, Mimouni O, Cathelinaud O, Allali L, Verdalle P. Clear-cell renal carcinoma metastasis to the base of the tongue and sphenoid sinus: Two very rare atypical ENT locations. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128:91-4. [DOI: 10.1016/j.anorl.2010.11.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Revised: 11/01/2010] [Accepted: 11/08/2010] [Indexed: 10/18/2022]
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Fyrmpas G, Adeniyi A, Baer S. Occult renal cell carcinoma manifesting with epistaxis in a woman: a case report. J Med Case Rep 2011; 5:79. [PMID: 21349191 PMCID: PMC3050834 DOI: 10.1186/1752-1947-5-79] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 02/24/2011] [Indexed: 11/25/2022] Open
Abstract
Introduction Metastatic disease in the sinonasal region occurs rarely and the primary site may be elusive. This case highlights the possibility of an occult renal tumor manifesting with nasal symptoms and the risk of severe bleeding following nasal biopsy. Case presentation We report the case of a 79-year-old Caucasian woman who presented with a six-week history of intermittent left-sided nosebleeds. She was fit, without previous surgery or anticoagulation. Nasal endoscopy and computed tomography showed a hemorrhagic mass occupying her left ethmoid cells and middle meatus. After a highly hemorrhagic biopsy, the lesion was histologically confirmed as clear cell carcinoma. Screening revealed a right kidney mass with widespread metastases. Palliative radiotherapy to the sinonasal metastasis and systemic treatment rendered her free of symptoms nine months after initial presentation. Conclusions General practitioners and ear, nose and throat (ENT) doctors are very often confronted with epistaxis. A small minority of patients with epistaxis show a primary or metastatic nasal mass. Detection of the origin of secondary sinonasal masses requires a high index of suspicion and examination of infraclavicular sites by a multidisciplinary team. Renal cell carcinoma metastases are prone to severe bleeding during any surgical intervention, therefore, preoperative embolization is recommended. Resection or radiotherapy to the sinonasal metastasis of renal origin is justified in order to prevent recurrent nosebleeds.
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Affiliation(s)
- Georgios Fyrmpas
- ENT Department, Conquest Hospital, The Ridge, St Leonards-on-Sea, East Sussex, TN37 7RD, UK.
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Hamdoon Z, Jerjes W, Upile T, Akram S, Hopper C. Metastatic renal cell carcinoma to the orofacial region: A novel method to alleviate symptoms and control disease progression. Photodiagnosis Photodyn Ther 2010; 7:246-50. [PMID: 21112547 DOI: 10.1016/j.pdpdt.2010.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 07/31/2010] [Accepted: 08/03/2010] [Indexed: 11/15/2022]
Abstract
Head and neck metastatic tumours are uncommon. The primary tumors most likely to metastasize are those of the thyroid, breast, and lungs. The management of metastatic carcinoma in the orofacial region is variable. Palliative and symptomatic approaches are the mainstay in the management. The purpose of this case report is to highlight the feasibility of using PDT to alleviate nasal and visual symptoms and control the growth of metastatic renal cell carcinoma to the orofacial region.
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Affiliation(s)
- Zaid Hamdoon
- UCLH Head and Neck Centre, London, United Kingdom.
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41
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Renal cell carcinoma presenting with cutaneous metastasis: a case report. Case Rep Med 2010; 2010. [PMID: 20811607 PMCID: PMC2929522 DOI: 10.1155/2010/913734] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Accepted: 07/01/2010] [Indexed: 12/18/2022] Open
Abstract
Renal cell carcinoma is the most common kidney tumor in adults. Cutaneous metastasis is a rare first symptom of the disease. This paper describes the diagnosis of a renal cell carcinoma that was indicated by cutaneous metastasis in the head and neck region, and considers the etiopathogenesis of such cases. A careful skin examination is important to detect cutaneous metastasis associated with renal cell carcinomas. Metastatic skin lesions in the head and neck region must be taken into consideration during a differential diagnosis.
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42
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Lingual metastasis as an initial presentation of renal cell carcinoma. Med Oncol 2010; 28:1389-94. [DOI: 10.1007/s12032-010-9596-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 06/03/2010] [Indexed: 01/05/2023]
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Affiliation(s)
- Eun-Ju Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bong-Jae Lee
- Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Ja Cho
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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44
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Bhatia S, Ng S, Hodder SC. Metastatic cutaneous head and neck renal cell carcinoma with no known primary: case report. Br J Oral Maxillofac Surg 2009; 48:214-5. [PMID: 20036041 DOI: 10.1016/j.bjoms.2009.11.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Accepted: 11/29/2009] [Indexed: 12/15/2022]
Abstract
Renal cell carcinoma represents 2-3% of all adult malignancies, and metastasis to the head and neck is a presenting complaint in 8% of these patients. Cutaneous facial renal cell carcinoma with no known primary renal tumour is unusual. We report a case of renal cell carcinoma of the nose with no known primary.
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Affiliation(s)
- Satyajeet Bhatia
- Morriston Hospital, ABM NHS Trust, Morriston Swansea, United Kingdom.
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45
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Abstract
A 45-year-old woman with metastatic renal cell carcinoma to the nasal septum was presented in this study. Metastatic neoplasms of the paranasal region are so rare that they have been usually reported as case reports. Although there are reported cases of renal cell carcinoma to the paranasal sinuses, this case was unique in that it is an isolated metastasis to the nasal septum. The clinical presentation, radiologic and pathologic investigations, and the treatment of patient with surgery and chemotherapy with sunitinib malate (Sutent) were discussed.
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46
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Ferlito, Ashok R. Shaha, J. Graham A. Metastatic Cervical Lymph Nodes from Urogenital Tract Carcinoma: A Diagnostic and Therapeutic Challenge. Acta Otolaryngol 2009. [DOI: 10.1080/00016480121086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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47
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JANKOWSKA P, TEOH EM, FISHER C, RHYS EVANS P, NUTTING CM, HARRINGTON KJ. Isolated intrathyroid metastasis from undifferentiated and squamous carcinoma of the head and neck: the case for surgery and re-irradiation. Br J Radiol 2008; 81:e154-61. [DOI: 10.1259/bjr/26919796] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Yeh HC, Yang SF, Ke HL, Lee KS, Huang CH, Wu WJ. Renal cell carcinoma presenting with skull metastasis: a case report and literature review. Kaohsiung J Med Sci 2007; 23:475-9. [PMID: 17766217 DOI: 10.1016/s1607-551x(08)70056-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The occurrence of metastasis to the head and neck region in renal cell carcinoma is extremely rare. An 80-year-old man presented with a soft nodule in the left parietal calvarium and was admitted to our hospital. Biopsy of the nodule showed nests of clear tumor cells, suggesting metastatic renal cell carcinoma. Computed tomography of the abdomen revealed a well-defined hypervascular tumor, measuring around 7 x 7 x 8 cm, exophytic from the lower pole of the right kidney. Since there were no other systemic metastases, right nephrectomy and complete resection of the skull lesion were performed. No adjunctive therapy was given postoperatively. After 22 months of follow-up, the patient was well and without evidence of disease.
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Affiliation(s)
- Hsin-Chih Yeh
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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49
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Torres Muros B, Solano Romero JR, Baró Rodriguez JG, Bonilla Parrilla R. [Maxillary sinus metastasis of renal cell carcinoma]. Actas Urol Esp 2007; 30:954-7. [PMID: 17175938 DOI: 10.1016/s0210-4806(06)73565-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Paranasal sinuses and nose metastasis are very uncommon tumors, about 50 have been reported. Renal cell carcinoma is the primary neoplasm which most frequently metastasizes in the nasosinusal region, followed by breast and lung. Symptoms are unspecific, but the epistaxis constitutes the most common sign due to the significant vascularizations of the tumor. Prognosis is poor. The survival rate fluctuates between 15-30% at 5 years. Surgery is the elective treatment.
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Affiliation(s)
- B Torres Muros
- Servicios de Otorrinolaringología, Hospital Clinico Virgen de la Victoria, Málaga.
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50
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Paiva MB, Sercarz JA, Pantuck AJ, Polyakov M, Figlin RA, Canalis RF, Castro DJ. Combined cytoreductive laser therapy and immunotherapy for palliation of metastatic renal cell carcinoma to the head and neck. Lasers Med Sci 2007; 22:60-3. [PMID: 17219256 DOI: 10.1007/s10103-006-0422-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2006] [Accepted: 09/22/2006] [Indexed: 10/23/2022]
Abstract
Interleukin-2 (IL-2) remains the mainstay of treatment for metastatic renal cell carcinoma (RCC), but minimally invasive surgical techniques have provided new options for the combined treatment of RCC. Two patients with metastatic RCC to the head and neck treated by combined laser-induced thermal therapy and IL-2 were described in this case report. Both patients had an extended survival compared to the historical survival of 10 months for metastatic RCC but eventually succumbed to progressive disease. The authors' initial experience with metastatic RCC suggests that laser thermoablation and immunotherapy in selected patients with metastatic RCC is warranted as a palliative treatment, but a larger study with long-term follow-up is necessary to determine the effectiveness of this approach.
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Affiliation(s)
- M B Paiva
- Division of Head and Neck Surgery, Department of Surgery, David Geffen School of Medicine-UCLA, 10833 Le Conte Avenue, CHS62-132, P.O. Box 162418, Los Angeles, CA 90095-1624, USA.
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