Recurrent epistaxis as manifestation of renal cell carcinoma sinonasal metastasis
Introduction. Renal cell carcinoma is the most frequent infraclavicular primary tumor metastasizing in the sinonasal region, although these metastases are not common. We present an unusual case of recurrent epistaxis as the initial sign of renal carcinoma sinonasal metastasis and discuss the diagnos...
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| Format: | Article |
| Language: | English |
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Serbian Medical Society
2019-01-01
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| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0370-8179/2019/0370-81791900035F.pdf |
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| author | Folić Miljan Trivić Aleksandar Pavlović Bojan Boričić Ivan Milovanović Jovica |
| author_facet | Folić Miljan Trivić Aleksandar Pavlović Bojan Boričić Ivan Milovanović Jovica |
| author_sort | Folić Miljan |
| collection | DOAJ |
| description | Introduction. Renal cell carcinoma is the most frequent infraclavicular primary tumor metastasizing in the sinonasal region, although these metastases are not common. We present an unusual case of recurrent epistaxis as the initial sign of renal carcinoma sinonasal metastasis and discuss the diagnostic and treatment options. Case outline. A 66-year-old patient was admitted to the hospital due to recurrent and severe epistaxis. The patient underwent nephrectomy due to renal cell carcinoma, with no signs of relapse during a three-year follow-up. Nasal endoscopy and computed tomography revealed a large mass in nasal cavity, spreading to the anterior and posterior ethmoid cells, sphenoid sinus, orbit, and anterior cranial fossa. Definite diagnosis of renal cell carcinoma metastasis in sinonasal region was made by a pathologist after biopsy and further radiological examination showed no signs of malignant disease in the abdomen, thorax, or pelvis. Although the patient had received 50 Gy of radiation therapy, the malignant disease was evaluated as progressive with further extension in anterior cranial fossa and maxilla, and the patient died five months after the occurrence of epistaxis. Conclusion. In patients with recurrent epistaxis who also had a history of renal carcinoma, endoscopic finding of tumefaction in the nasal cavity should raise a suspicion of sinonasal metastasis. In such cases, biopsy is mandatory to differentiate a metastasis from primary sinonasal tumors. Histological confirmation should be followed by radiological examination of the abdomen, thorax, and pelvis to evaluate the possibility of renal cell carcinoma recurrence or metastatic dissemination elsewhere. |
| first_indexed | 2024-12-14T21:21:34Z |
| format | Article |
| id | doaj.art-22b3a23aedc14b8b9c8ffee77872d2cb |
| institution | Directory Open Access Journal |
| issn | 0370-8179 |
| language | English |
| last_indexed | 2024-12-14T21:21:34Z |
| publishDate | 2019-01-01 |
| publisher | Serbian Medical Society |
| record_format | Article |
| series | Srpski Arhiv za Celokupno Lekarstvo |
| spelling | doaj.art-22b3a23aedc14b8b9c8ffee77872d2cb2022-12-21T22:46:56ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792019-01-011475-636436710.2298/SARH181231035F0370-81791900035FRecurrent epistaxis as manifestation of renal cell carcinoma sinonasal metastasisFolić Miljan0Trivić Aleksandar1Pavlović Bojan2Boričić Ivan3Milovanović Jovica4Clinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade + Faculty of Medicine, BelgradeClinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade + Faculty of Medicine, BelgradeClinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade + Faculty of Medicine, BelgradeFaculty of Medicine, Institute of Pathology, BelgradeClinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade + Faculty of Medicine, BelgradeIntroduction. Renal cell carcinoma is the most frequent infraclavicular primary tumor metastasizing in the sinonasal region, although these metastases are not common. We present an unusual case of recurrent epistaxis as the initial sign of renal carcinoma sinonasal metastasis and discuss the diagnostic and treatment options. Case outline. A 66-year-old patient was admitted to the hospital due to recurrent and severe epistaxis. The patient underwent nephrectomy due to renal cell carcinoma, with no signs of relapse during a three-year follow-up. Nasal endoscopy and computed tomography revealed a large mass in nasal cavity, spreading to the anterior and posterior ethmoid cells, sphenoid sinus, orbit, and anterior cranial fossa. Definite diagnosis of renal cell carcinoma metastasis in sinonasal region was made by a pathologist after biopsy and further radiological examination showed no signs of malignant disease in the abdomen, thorax, or pelvis. Although the patient had received 50 Gy of radiation therapy, the malignant disease was evaluated as progressive with further extension in anterior cranial fossa and maxilla, and the patient died five months after the occurrence of epistaxis. Conclusion. In patients with recurrent epistaxis who also had a history of renal carcinoma, endoscopic finding of tumefaction in the nasal cavity should raise a suspicion of sinonasal metastasis. In such cases, biopsy is mandatory to differentiate a metastasis from primary sinonasal tumors. Histological confirmation should be followed by radiological examination of the abdomen, thorax, and pelvis to evaluate the possibility of renal cell carcinoma recurrence or metastatic dissemination elsewhere.http://www.doiserbia.nb.rs/img/doi/0370-8179/2019/0370-81791900035F.pdfepistaxisrenal cell carcinomaneoplasm metastasisnasal cavity |
| spellingShingle | Folić Miljan Trivić Aleksandar Pavlović Bojan Boričić Ivan Milovanović Jovica Recurrent epistaxis as manifestation of renal cell carcinoma sinonasal metastasis Srpski Arhiv za Celokupno Lekarstvo epistaxis renal cell carcinoma neoplasm metastasis nasal cavity |
| title | Recurrent epistaxis as manifestation of renal cell carcinoma sinonasal metastasis |
| title_full | Recurrent epistaxis as manifestation of renal cell carcinoma sinonasal metastasis |
| title_fullStr | Recurrent epistaxis as manifestation of renal cell carcinoma sinonasal metastasis |
| title_full_unstemmed | Recurrent epistaxis as manifestation of renal cell carcinoma sinonasal metastasis |
| title_short | Recurrent epistaxis as manifestation of renal cell carcinoma sinonasal metastasis |
| title_sort | recurrent epistaxis as manifestation of renal cell carcinoma sinonasal metastasis |
| topic | epistaxis renal cell carcinoma neoplasm metastasis nasal cavity |
| url | http://www.doiserbia.nb.rs/img/doi/0370-8179/2019/0370-81791900035F.pdf |
| work_keys_str_mv | AT folicmiljan recurrentepistaxisasmanifestationofrenalcellcarcinomasinonasalmetastasis AT trivicaleksandar recurrentepistaxisasmanifestationofrenalcellcarcinomasinonasalmetastasis AT pavlovicbojan recurrentepistaxisasmanifestationofrenalcellcarcinomasinonasalmetastasis AT boricicivan recurrentepistaxisasmanifestationofrenalcellcarcinomasinonasalmetastasis AT milovanovicjovica recurrentepistaxisasmanifestationofrenalcellcarcinomasinonasalmetastasis |