Epístaxis como primera manifestación de un adenocarcinoma renal diseminado

Arias, J.G. Pereira; jaime, V. Ullate; Díez, José María Gutiérrez; Martin, François; Pérez, Valadez; Díaz-Obregón, Ricardo Ateca; Gallastegui, José Ramón Berreteaga

doi:10.1016/s0210-4806(02)72791-5

Cited by 14 publications

(3 citation statements)

References 11 publications

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“…Biopsy of a suspicious nasal lesion is imperative to guide further workup, but severe hemorrhage may occur [11]. Some authors advocate selective embolization prior to tumor biopsy particularly if there is a known history of nephrectomy [10,12]. Biopsy of RCC nasal metastasis may prove non-diagnostic due to diffuse necrosis of the lesion so several attempts are sometimes necessary [11].…”

Section: Discussionmentioning

confidence: 99%

Occult renal cell carcinoma manifesting with epistaxis in a woman: a case report

2011

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IntroductionMetastatic disease in the sinonasal region occurs rarely and the primary site may be elusive. This case highlights the possibility of an occult renal tumor manifesting with nasal symptoms and the risk of severe bleeding following nasal biopsy.Case presentationWe report the case of a 79-year-old Caucasian woman who presented with a six-week history of intermittent left-sided nosebleeds. She was fit, without previous surgery or anticoagulation. Nasal endoscopy and computed tomography showed a hemorrhagic mass occupying her left ethmoid cells and middle meatus. After a highly hemorrhagic biopsy, the lesion was histologically confirmed as clear cell carcinoma. Screening revealed a right kidney mass with widespread metastases. Palliative radiotherapy to the sinonasal metastasis and systemic treatment rendered her free of symptoms nine months after initial presentation.ConclusionsGeneral practitioners and ear, nose and throat (ENT) doctors are very often confronted with epistaxis. A small minority of patients with epistaxis show a primary or metastatic nasal mass. Detection of the origin of secondary sinonasal masses requires a high index of suspicion and examination of infraclavicular sites by a multidisciplinary team. Renal cell carcinoma metastases are prone to severe bleeding during any surgical intervention, therefore, preoperative embolization is recommended. Resection or radiotherapy to the sinonasal metastasis of renal origin is justified in order to prevent recurrent nosebleeds.

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Section: Discussionmentioning

confidence: 99%

Occult renal cell carcinoma manifesting with epistaxis in a woman: a case report

2011

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“…One of the first reports available in recent literature to describe a renal clear cell carcinoma metastatic to the paranasal sinuses has been published by Matsumoto and Yanagihara in 1982 [ 26 ]; afterwards several authors described case reports of RCC presenting as metastatic diseases in the paranasal sinuses. Available literature describes presentation of RCC metastasis as a solitary periorbital [ 27 ] and orbital mass [ 28 ], as a frontal sinus mass [ 29 ], as an ethmoid sinus mass [ 30 , 31 ], in the nasal cavity [ 32 , 33 ], in the maxillary [ 34 , 35 ], and sphenoid sinus [ 36 – 38 ]. In some cases, the extension of the metastasis to the skull base has been described [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Renal Cell Carcinoma Presenting as a Paranasal Sinus Mass: The Importance of Differential Diagnosis

Ralli

Altissimi

Turchetta

et al. 2017

Case Reports in Otolaryngology

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Metastases in the paranasal sinuses are rare; renal cell carcinoma is the most common cancer that metastasizes to this region. We present the case of a patient with a 4-month history of a rapidly growing mass of the nasal pyramid following a nasal trauma, associated with spontaneous epistaxis and multiple episodes of hematuria. Cranial CT scan and MRI showed an ethmoid mass extending to the choanal region, the right orbit, and the right frontal sinus with an initial intracranial extension. Patient underwent surgery with a trans-sinusal frontal approach using a bicoronal incision combined with an anterior midfacial degloving; histological exam was compatible with a metastasis of clear cell renal cell carcinoma. Following histological findings, a total body CT scan showed a solitary 6 cm mass in the upper posterior pole of the left kidney identified as the primary tumor. Although rare, metastatic renal cell carcinoma should always be suspected in patients with nasal or paranasal masses, especially if associated with symptoms suggestive of a systemic involvement such as hematuria. A correct early-stage diagnosis of metastatic RCC can considerably improve survival rate in these patients; preoperative differential diagnosis with contrast-enhanced imaging is fundamental for the correct treatment and follow-up strategy.

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“…Un 11 % de las metástasis de los carcinomas de células renales tienen su asiento en el sistema nervioso central, siendo la afectación metastá-sica solitaria del sistema nervioso central muy infrecuente [2][3][4][5] . Sin embargo, en nuestro caso la afectación neurológica del paciente no fue debida a metás-tasis, sino a un síndrome paraneoplásico, aparecido años antes de los síntomas habituales del tumor, como ha sido previamente descrito 1 .…”

Section: Discussionunclassified

Carcinoma renal que debuta como cuadro neurológico paraneoplásico

Hens¹,

Camacho²,

Maestre³

et al. 2008

Actas Urol Esp

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RESUMENCARCINOMA RENAL QUE DEBUTA COMO CUADRO NEUROLÓGICO PARANEOPLÁSICO Introducción: Los procesos tumorales pueden de manera ocasional mostrar su primera manifestación con una sintomatología neurológica, no originada por metástasis, sino del denominado tipo paraneoplási-co, que puede aparecer incluso años antes de los síntomas habituales del tumor. Este tipo de manifestaciones iniciales pueden ser la clave del descubrimiento de una neoplasia oculta.Métodos: Presentamos el caso de un varón de 66 años afecto de un carcinoma renal, cuya manifestación inicial consistió únicamente en un cuadro neurológico progresivo de tipo cerebeloso paraneoplásico, aparecido 6 años antes de la primera sintomatología urológica.Conclusiones: La aparición de una sintomatología neurológica cerebelosa progresiva puede ser la única y primera manifestación de un carcinoma renal, incluso años antes de las primeras manifestaciones uroló-gicas. Debe sospecharse la existencia de una neoplasia oculta en los pacientes con esta sintomatología. ABSTRACTRENAL CELL CARCINOMA PRESENTING AS PARANEOPLASTIC NEUROLOGICAL DYSFUNCTION Introduction: Malignant tumors sometimes initiate as paraneoplastic syndromes even years before the most common symptoms appear. These first manifestations could be the key for the diagnosis of "occult" malignancy.Methods: We report the case of a 66 year old man with a renal cell carcinoma. The first symptom was a paraneoplastic cerebellar degeneration appeared 6 years before the first urologic manifestations.Conclusions: A progressive cerebellar syndrome could be the first manifestation of a renal cell carcinoma, even years before the first urologic symptoms. We must suspect an occult neoplasia in such patients.

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Epístaxis como primera manifestación de un adenocarcinoma renal diseminado

Cited by 14 publications

References 11 publications

Occult renal cell carcinoma manifesting with epistaxis in a woman: a case report

Occult renal cell carcinoma manifesting with epistaxis in a woman: a case report

Metastatic Renal Cell Carcinoma Presenting as a Paranasal Sinus Mass: The Importance of Differential Diagnosis

Carcinoma renal que debuta como cuadro neurológico paraneoplásico

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