Letter to the Editor - Metastatic Renal Cell Carcinoma involving Ethmoid Sinus at Presentation
A 57-year-old, normotensive man presented with a one month history of throbbing headache in the right frontal region and three episodes of epistaxis. His otolaryngologic, ophthalmic and systemic examinations were normal. X-ray of paranasal sinuses showed haziness in the right ethmoid region. CT scan...
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Published in | Journal of postgraduate medicine (Bombay) Vol. 49; no. 1 |
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Main Author | |
Format | Journal Article |
Published |
India
Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India
18.06.2003
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Online Access | Get full text |
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Summary: | A 57-year-old, normotensive man presented with a one month history of
throbbing headache in the right frontal region and three episodes of
epistaxis. His otolaryngologic, ophthalmic and systemic examinations
were normal. X-ray of paranasal sinuses showed haziness in the right
ethmoid region. CT scan of the head showed a soft tissue mass in the
right ethmoid region with erosion of the medial wall of the right
orbit. Biopsy of the mass on histopathological examination was reported
as metastatic clear cell carcinoma. Possibility of primary lesion in
the parotid or kidney was suggested. Ultrasonography of the abdomen
detected a mixed echogenic mass with irregular and well defined margins
and CT scan revealed a non-homogenously enhancing mass at the upper
pole of right kidney. CT guided biopsy of the renal mass showed
features of clear cell carcinoma. A near total excision of the mass
with medial wall of the maxilla , medial orbit and ethmoids via
extended Weber-Furguson incision was performed under general
anaesthesia. The surgical margins were positive for the tumour. Thus,
the patient received post operative radiotherapy. He observed complete
relief from symptoms. He refused any surgical procedure for the
asymptomatic lesion in his right kidney; thus he was put on hormone
therapy (Megestral acetate 300 mg/day). He continues to be in good
health and there is no progression of his primary disease or appearance
of new metastatic lesions during thirty months post treatment period. |
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ISSN: | 0022-3859 |