Renal Cell Carcinoma with Facial Swelling and Nasal Obstruction as Primary Presentation

Authors

  • Mohd Naqib Mohd Sabri Department of Radiology, Hospital Pengajar Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
  • Kasumawati Alli Radiology Unit, ParkCity Medical Centre, Kuala Lumpur, Malaysia
  • Sze Yin Lam Department of Biomedical Imaging, Faculty of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
  • Kharul Azmi Abdul Kadir Department of Biomedical Imaging, Faculty of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
  • Norafida Bahari Department of Radiology, Hospital Pengajar Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia

DOI:

https://doi.org/10.32896/cvns.v4n2.49-54

Keywords:

Renal neoplasm, Neoplasm metastasis, Paranasal sinuses, Clear cell renal cell carcinoma, Biopsy

Abstract

Background: Renal cell carcinoma (RCC) is a slow growing tumor. About 25–30% of patients are found to have metastases at diagnosis commonly to lung, liver and bones. The incidence of renal cell carcinoma metastasizing to the head and neck has been reported to range from 15-30%. Intranasal mass, or occasionally orbital mass maybe the presenting symptom of metastatic renal cell carcinoma to the nose and sinuses.

Case presentation: We report a case of left RCC with large metastases to the frontonasal region producing head and neck symptoms before the primary lesion could be detected. Clinical presentations of metastatic RCC to the nasal and paranasal regions varies from recurrent epistaxis, nasal obstruction, facial pain, induration or even an orbital mass. In our case, although the patient had typical presentation of metastatic nasal tumour, the diagnosis of metastatic disease was not made.

Conclusion: Patient presented with nasal and paranasal region tumour with no other systemic symptoms, presence of metastatic disease particularly from renal cell carcinoma should be included in diagnosis, as it is a slow growing tumour and the fact that nasal and paranasal areas are the most commonly affected site of metastatic RCC in the head and neck region.

References

D R Nayak, K Pujary, S Ramnani, C Shetty, P Parul. Metastatic renal cell carcinoma presenting with epistaxis. Indian Journal of Otolaryngology and Head and Neck Surgery. 2006 October – December; 58(4).

Ricard S, Andrew JS, Simon PH, Patrick RA, Andrew RB, Nick JS, W Trevor Farrington. Metastatic renal cell carcinoma to the nose and paranasal sinuses. Head Neck. 2000 Jan; 22: 722–727.

Homer JJ, Jones NS. Renal cell carcinoma presenting as a solitary paranasal sinus metastasis. J Laryngol Otol 1995;109:986–989.

Tunio MA, Hashmi A, Rafi M. Epistaxis and Proptosis - Unusual primary manifestations of metastatic renal cell carcinoma. Pak J Med Sci 2009;25(6):1012-1014.

Matsumoto Y, Yanagilhara N. (1982): Renal cell carcinoma metastatic to the nose and paranasal sinuses. Laryngoscope 92:1190-1193. .

Yoshimura T, Suenaga T, Kozaki H, Oohashi N, Sakai N. A case of renal cell carcinoma revealed by metastasis to the nasal cavity and paranasal sinuses. Sapporo Hosp Med 1989; 49: 31–5.

Miyahara H. Metastastic carcinoma to head and neck lesion. J Otolaryngol Jpn 1983; 86: 951–7.

Bernstein JM, Montgomery MD, Balogh K Jr. Metastatic tumors to maxilla, nose, and paranasal sinuses. Laryngoscope 1966; 76: 621–50.

Lapinski JE, Chen L, Zhou M. Distinguishing clear cell renal cell carcinoma, retroperitoneal paraganglioma, and adrenal cortical lesions on limited biopsy material: utility of immunohistochemical markers. Appl Immunohistochem Mol Morphol. 2010 Oct;18(5):414-21.

Caunter G, Faeez Md Noh MS, Safri LS, Kumar K, Md Idris MA, Harunarashid H, Yahaya A. Delayed Presentation of Metastatic Renal Cell Carcinoma as an Arteriovenous Malformation Mimicking Vascular Tumour of the Forearm. EJVES Short Rep. 2019 Jul 31;44:19-22.

Albandar HJ, Roberto ES, See JR and Sabiers JH: Arteriovenous malformation and thyroid metastasis from underlying renal cell carcinoma, an unusual presentation of malignancy: A case report. Oncol Lett 13: 3323-3327, 2017

Downloads

Published

2022-06-30

How to Cite

Mohd Sabri, M. N., Alli, K., Lam, S. Y., Abdul Kadir, K. A., & Bahari, N. (2022). Renal Cell Carcinoma with Facial Swelling and Nasal Obstruction as Primary Presentation. Journal Of Cardiovascular, Neurovascular &Amp; Stroke, 4(2), 49–54. https://doi.org/10.32896/cvns.v4n2.49-54