Atypical metastasis of renal cell carcinoma to the uvula: case report and review of literature

Abstract

Renal cell carcinoma (RCC) is a common malignancy with high metastatic potential, primarily due to its extensive vascularity. Common sites of metastasis include lungs, bone, lymph nodes, liver, and brain. However, rare cases of metastasis to other sites including inguinal lymph nodes, peritoneum/mesentery, and orbit have been published in the literature. Herein, a unique case involving metastasis of RCC to the uvula is presented. The patient is a 55-year-old White female with a past medical history of stage 3 (T3aN0M0) RCC s/p nephrectomy 3 years prior to presentation. She had symptoms of a foreign body sensation at the back of her throat, and oropharyngeal examination revealed uvular erythematous mass with vascularity. Uvular biopsy and complete excision were performed, which revealed metastatic RCC. Palate biopsy was negative and revealed only squamous mucosa with mild chronic inflammation. To our knowledge, there is only one other documented case of RCC metastasis to the uvula in the literature.

Renal cell carcinoma uvula metastasis leading to airway compromise: an unusual site

“…Being readily visible, and with the potential for even small masses to cause troublesome symptoms, patients will usually present promptly with lesions of the uvula. The uvula metastases described by Khade and Devarakonda,6 and in the current case, were discovered in patients that already had wide-spread metastasis. This is in keeping with the theory of spread described above, in which metastases in the head and neck are most commonly seeded from deposits in the lung.…”

“…The patient had undergone several surgeries, including right nephrectomy, Whipple’s procedure for pancreatic metastases and endoscopic sinus surgery for metastases to her left ethmoid sinus and nasal cavity. She presented a year later with vague nasal symptoms, and while an MRI did not detect the tumour, a 2 mm uvula mass was identified on examination of the oropharynx 6. The tumour described in the current case was considerably larger, thereby accounting for the more clearly defined symptomology.…”

“…Rarer locations have been noted in the literature, including inguinal lymph nodes, peritoneum and orbit 2–4. Metastatic spread of RCC to the uvula has been reported on two occasions; in one case it was the presenting complaint,5 while the other case presented 3 years after initial diagnosis and had been preceded by metastatic spread to the nasal cavity and maxillary sinus 6…”

Metatarsal metastasis from clear cell renal cell carcinoma: a case report and literature review

“…RCC is commonly known to metastasize to the lungs, bone, and brain, but RCC can metastasize to some atypical sites as well, such as skeletal muscle [4], scalp [5] and uvula [6], as described in the literature. This report describes the metastasis of clear cell renal cell carcinoma to the metatarsus.…”