Metastatic renal cell carcinoma to the nose and paranasal sinuses.

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.