Koscielny S
HNO-Klinik der Friedrich-Schiller-Universität Jena.
Laryngorhinootologie. 1999 Aug;78(8):441-4. doi: 10.1055/s-2007-996905.
Malignant tumors very seldom establish metastasis in the paranasal sinuses. Renal cell carcinomas (RCC) are one of the possible primary tumors displaying metastases in this location. The incidence of metastasis from the renal cell carcinoma in the paranasal sinuses is higher as would be expected by the incidence of this tumor.
We report here about 3 patients from the ENT clinic with metastasis in the paranasal sinus derived from primary RCC. Two of them showed metastases in the maxillary sinus and the third patient had a metastasis in the sphenoid sinus.
Further progression of the patients disease exhibited the paranasal sinuses being only a localisation of the generalised tumor disease. 2 of 3 patients developed the metastasis many years after nephrectomy and the third patient displayed a renal cell carcinoma by the diagnosis of a paralysis of the abducens nerve. All patients were treated with radiation of the tumor, but in one case with a metastasis in the maxillary sinus the tumor was also treated surgically. 2 of the 3 patients (one with a metastasis in the maxillary sinus and the other in the sphenoidal sinus) were inoperable due to the expanded tumor size. Nowadays surgical resection of the tumor seems to be the only therapy. In the follow-up all patients developed multiple distant metastasis. With respect to the quality of life of the patients the indication of a radical operation should be discussed very critically. Palliative methods, like interferon-therapy or selective embolisation of tumor, may also reduce the symptoms of the tumor and increase the quality of life for the patients.
恶性肿瘤很少在鼻窦发生转移。肾细胞癌（RCC）是可能在此部位发生转移的原发性肿瘤之一。鼻窦肾细胞癌转移的发生率高于该肿瘤的预期发生率。
我们在此报告3例来自耳鼻喉科门诊的患者，其鼻窦转移源自原发性肾细胞癌。其中2例上颌窦有转移，第3例患者蝶窦有转移。
患者疾病的进一步进展表明鼻窦仅是全身性肿瘤疾病的一个部位。3例患者中有2例在肾切除术后多年发生转移，第3例患者因外展神经麻痹诊断为肾细胞癌。所有患者均接受了肿瘤放疗，但1例上颌窦转移患者还接受了手术治疗。3例患者中有2例（1例上颌窦转移，另1例蝶窦转移）因肿瘤体积扩大无法手术。如今，肿瘤的手术切除似乎是唯一的治疗方法。在随访中，所有患者均发生了多处远处转移。就患者的生活质量而言，应非常审慎地讨论根治性手术的指征。姑息性方法，如干扰素治疗或肿瘤的选择性栓塞，也可能减轻肿瘤症状并提高患者的生活质量。
