A CASE INVOLVING THE METASTASIS OF RENAL CELL CARCINOMA TO THE MAXILLARY SINUS

• Published in: JIBI INKOKA TEMBO Vol. 43; no. 5; pp. 403 - 410
• Main Authors: Iino, Takashi, Mitani, Yukie, Yabe, Takeshi, Kojima, Hiromi, Yoshida, Ryuichi, Sato, Hideaki, Iimura, Jiro, Wada, Kota, Umezawa, Yuji
• Format: Journal Article
• Language: Japanese
• Published: Society of Oto-rhino-laryngology Tokyo 2000
• Subjects: metastatic malignant tumor; multiple organ metastases; paranasal sinuses; QOL; renal cell carcinoma
• ISSN: 0386-9687; 1883-6429
• DOI: 10.11453/orltokyo1958.43.403

Renal cell carcinoma often metastasizes to the lung, bones, and liver, but rarely to the otolaryngologic organs. After citing some references, this report presents a patient with renal cell carcinoma, that metastasized to the maxillary sinus and lungs.The patient survived for seven years and seven months by undergoing conservative therapy. When renal cell carcinoma metastasizes to the maxillary or ethmoidal sinuses, massive nasal hemorrhage often necessitates frequent blood transfusions. Also, as the metastasized tumor grows, exophthalmus and dermal infiltration can cause double vision and changes in facial features. Tumor progression in the mouth region can cause eating impairment. When these conditions lower the patient's QOL, the metastasized paranasal sinus tumors should be resected. Even if the renal cell carcinoma has metastasized to other organs, such as the lung, the paranasal sinus tumors should be resected as long as the prognosis is relatively favorable, i.e. the following conditions are met : (1) recurring massive nasal hemorrhage, (2) the metastatic paranasal tumor has not progressed into the orbit, base of the skull, epipharynx, sphenoid sinus, frontal sinus or skin on the back of the nose, and its TNM classification is not severer than T 3. (3) the tumor cells are not spindle-type cells, (4) grade 1 cell atypism, (5) delayed-type tumor progression, (6) diploid tumor cells confirmed by a ploidy analysis of intranuclear DNA, and (7) treatment with interferon therapy and chemotherapy for metastatic tumors in other organs. When these conditions are satisfied, the metastasized paranasal sinus tumors should be resected even if the renal cell carcinoma has metastasized to other organs.