Metastatic renal cell carcinoma to the nose and paranasal sinuses

Background. Renal cell carcinoma represents 3% of all malignant tumors. Met astatic deposits of renal cell carcinoma to the head and neck region are in frequent. The objective of this work is to analyze the clinical presentatio n, radiologic features. surgical and radiotherapy treatment, and outcome of metastatic renal cell carcinoma to the nose and sinuses. Methods. Retrospective review of 6 patients diagnosed with renal cell carci noma who had nasal metastasis develop and were seen at the Christie Hospita l in Manchester over the past 8 years. Results. Six patients with renal cell carcinoma were seen with recurrent ep istaxis, nasal obstruction, and unpleasant nasal crusting. Three patients h ad orbital involvement. Examination under general anaesthesia and biopsy wa s performed in all 6 cases. Histologic studies confirmed metastases of rena l cell carcinoma in all 6 patients. All patients underwent local external b eam radiotherapy. The most common dose used was 35 Gy in 8 daily fractions. All patients had symptomatic control of local nasal disease with a minimum follow-up of 2 years in 4 patients. Two patients died within 6 months of t he radiotherapy treatment as a result of their primary tumor. Conclusions. Metastatic renal cell carcinoma to the nose and paranasal sinu ses is rare but has unpleasant symptoms. Local symptomatic control with rad iotherapy is excellent. (C) 2000 John Wiley & Sons, Inc.