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原发性额窦和眼眶肿瘤提示肾癌远处转移较晚。

Initial Frontal Sinus and Orbit Tumor Signaling Late Distant Metastasis in Kidney Cancer.

作者信息

Pavlovic Bojan, Jakovljevic Sasa, Jovanovic Katarina

机构信息

Faculty of Medicine, University of Belgrade.

Clinic of Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Belgrade, Serbia.

出版信息

J Craniofac Surg. 2024 Sep 10. doi: 10.1097/SCS.0000000000010626.

Abstract

Although metastases to the paranasal sinuses are exceedingly rare, when they do occur, renal clear cell carcinoma is the most frequent primary tumor involved. The aim of this work was to present a case of metastatic clear cell renal carcinoma in the frontal sinus and orbit region, 7 years after the initial diagnosis and treatment. The patient was referred to our clinic due to drooping of the left eyelid and displacement of the left eyeball. Computed tomography revealed an expansive lesion in the left frontal sinus and orbit, causing destruction of its anterior, lateral, and roof walls. Profuse bleeding from the tumor and left orbit hindered a comprehensive assessment of tumor extension into the orbit and residual tumor size. Therefore, complete tumor removal was not possible; instead, reduction was achieved. Subsequent histopathologic and immunohistochemical analysis confirmed the lesion as a metastasis of renal cell carcinoma in the sinonasal tract. Unfortunately, 10 weeks later, the patient passed away. Treatment of metastatic clear cell renal carcinoma depends on the localization of the disease as well as the overall condition of the patient. If there is a solitary metastatic lesion, as in the case of the sinonasal region, surgical treatment is recommended. Metastasis of clear cell renal carcinoma to the sinonasal region is a rare occurrence; however, it is essential to consider it in cases of rapidly growing tumor masses, typically presenting with symptoms such as epistaxis and nasal obstruction.

摘要

尽管转移至鼻窦极为罕见,但一旦发生,肾透明细胞癌是最常涉及的原发肿瘤。本研究旨在呈现一例在初次诊断和治疗7年后发生于额窦和眼眶区域的转移性透明细胞肾细胞癌病例。该患者因左眼睑下垂和左眼球移位前来我院就诊。计算机断层扫描显示左额窦和眼眶有一占位性病变,导致其前壁、外侧壁和顶壁破坏。肿瘤和左眼眶大量出血妨碍了对肿瘤向眼眶扩展及残留肿瘤大小的全面评估。因此,无法完整切除肿瘤,仅实现了肿瘤减瘤。随后的组织病理学和免疫组化分析证实该病变为鼻窦道肾细胞癌转移。不幸的是,10周后患者去世。转移性透明细胞肾细胞癌的治疗取决于疾病的定位以及患者的整体状况。如果存在孤立性转移病灶,如鼻窦区域的情况,建议进行手术治疗。透明细胞肾细胞癌转移至鼻窦区域较为罕见;然而,对于快速生长的肿瘤肿块,通常表现为鼻出血和鼻塞等症状的病例,必须考虑到这种情况。

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