Occult renal cell carcinoma manifesting as nasal mass and epistaxis

Abstract

Metastasis of renal cell carcinoma (RCC) to the nasal cavity and paranasal sinuses is rare, with fewer than 50 cases described in the literature. Nasal metastasis as the initial presentation of RCC is even rarer. Metastases to the nasal cavity usually represent advanced disease with poor outcome. The authors report a case of metastatic RCC presenting with right nasal cavity mass and epistaxis, followed by a brief review of the relevant literature.

Keywords: Epistaxis; Nasal metastasis; Renal cell carcinoma.

Figure 1

Photograph of the patient who presented with epistaxis, showing right proptosis and edema of right eyelids.

Figure 2

Magnetic resonance imaging showing an expanding mass (3.6 × 1.7 × 2.7 cm) present in the right nasal cavity and compressing the medial walls of the right maxillary sinus and right orbit.

Figure 3

Coronal section magnetic resonance imaging showing the mass invading into the medial posterosuperior quadrant of the right orbit leading to proptosis.

Figure 4

Computed tomography scan of the abdomen of the same patient showed an ill-defined, heterogeneous upper polar renal mass (10 × 8 × 7 cm).