[Renal cell carcinoma metastases to nose and paranasal sinuses presenting as recurrent epistaxis]

Distant metastases in head and neck region are very uncommon. Nasal bleeding was the first symptom in a patient with metastasis from renal cell carcinoma. Nasal tumour biopsy revealed renal carcinoma to be the primary lesion. Initially the patient refused surgery and nephrectomy was performed 8 months later. MR scans demonstrated diffuse intracranial invasion which made complete removal impossible. Potential routes of renal carcinoma spread are presented. Renal cell carcinoma should be considered in the diagnosis of nose and paranasal tumours. Epistaxis can be the first symptom of renal carcinoma metastasis to the nose and paranasal sinuses.