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Published on: September 22, 2023
Epistaxis: the cause found beyond the nose
Rahul Verma1, Vinay Nagaraja Gowda1, Ashok Singh1
1All Institute of Medical Science Rishikesh, Department of Pathology. Rishikesh, Uttarakhand, India.
Metastatic renal cell carcinoma (RCC) rarely affects the head and neck, particularly the paranasal sinuses. This case highlights the importance of considering RCC metastasis in asymptomatic patients with unexplained nasal masses.
Area of Science:
- Oncology
- Radiology
- Pathology
Background:
- Renal cell carcinoma (RCC) is a kidney malignancy often diagnosed at a metastatic stage.
- Head and neck metastases account for up to 3% of metastatic RCC cases.
- The paranasal sinuses are an exceptionally rare site for RCC metastasis.
Observation:
- A 74-year-old female presented with a traumatic nasal bleed.
- Imaging revealed a fronto-ethmoidal mass with pachymeningeal involvement.
- Histopathology confirmed metastatic clear cell carcinoma, identified as RCC via immunohistochemistry.
Findings:
- Radiological examination identified an asymptomatic, exophytic mass in the kidney.
- The patient had no renal complaints, making the metastasis unexpected.
- This represents a rare instance of asymptomatic metastatic RCC to the fronto-ethmoidal sinus.
Implications:
- Considering metastatic RCC in the differential diagnosis for unexplained head and neck masses is crucial.
- Early detection of rare metastatic sites can lead to timely treatment.
- Prompt diagnosis and management of metastatic RCC can improve patient survival rates.
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