We investigated the incidence of extracapsular spread (ECS) and the impact of ECS on contralateral neck metastasis in 67 patients with ipsilateral nodal metastasis (IpN+) whose records were extracted retrospectively from those of 155 laryngeal cancer patients. The incidence of ECS in association with variables was determined: T stage, N stage, tumor location, tumor extension, number of positive nodes, and contralateral neck status. The variables were evaluated to identify their impact on the rates of contralateral neck metastasis (CNM) and 3-year survival. Of the 67 patients, 30 (44.7%) had ECS. A significant relationship was found between ECS positivity and increased N stage, tumor extension up to the midline, number of positive nodes, and CNM (p = .04, p = .0001, p = .018, p = .0001, respectively). Multivariate analysis revealed that N stage (p = .002; odds ratio, 3.5517) and the presence of ECS (p = .0036; odds ratio, 7.7840) in IpN+ were associated with the greatest risk of CNM. The 3-year survival rate of patients with ipsilateral ECS was significantly lower than that of patients without ECS (43% versus 81%, p = .0002). Both CNM and presence of ECS in IpN+ emerged as significant independent predictors for survival with Cox multivariate analysis (p = .0086 and p = .0234, respectively). This result indicates the necessity of treating the contralateral N0 neck in cases of IpN+ with ECS.

Colloid cysts are the most common third ventricle lesions and metastasis to this area is rare. We presented a case of solitary metastasis from a renal cell carcinoma to the third ventricle choroid plexus mimicking a colloid cyst. A 53-year-old man, who had a history of renal cell carcinoma 12 years ago, was operated for single third ventricle lesion and hydrocephalus via a transcallosal approach. Total removal could not be performed due to intraoperative massive bleeding. Histological examination revealed a metastatic renal cell carcinoma. The patient died on the postoperative 13 th day because of bleeding from the residual tumor. Stereotactic radiosurgery and ventriculoperitoneal shunting might be favorable in such cases in order to avoid serious complications. KeywOrds: Renal cell carcinoma, Choroid plexus, Third ventricle, Metastasis, Colloid cyst ÖZÜçüncü ventrikülün en sık görülen lezyonları kolloid kistlerdir ve bu bölgeye metastazlar çok nadir gözlenir. Biz, görünümü kolloid kiste benzeyen, renal hücreli karsinomun 3. ventrikül koroid pleksusuna metastazı olan bir olguyu bildirdik. Elli üç yaşında, 12 yıl önce renal hücreli karsinom tanısı alan, erkek hasta; tek 3. ventrikül metastazı ve hidrosefali nedeni ile opere edildi. Aşırı intraoperatif kanama nedeni ile tümör tamamen çıkartılamadı. Histolojik sonuç, renal hücreli karsinom metastazı idi. Hasta rezidüel tümör içerisine ve oluşan kanama nedeniyle ameliyat sonrası 13. günde öldü. Bu tür hastalarda cerrahi girişimin yaratacağı ciddi komplikasyonları engellemek için stereotaktik radyocerrahi ve ventriküloperitoneal şant tedavisi daha uygun olabilir.