title: An unusual presentation of a metastatic hypernephroma to the frontonasal region.
abstract: We report a rare case involving an 85-year-old man who presented with a large metastatic hypernephroma to the frontal sinuses, the base of the nose, and the ethmoid sinuses, disfiguring the patient's face. Frequent but intermittent and mild epistaxis was one of the main symptoms. He had no history of renal malignancy, and even at the time of our examination (18 months after the appearance of the facial tumor) he did not have any symptoms of the primary renal carcinoma (not even hematuria). This metastasis may have occurred through the vertebral plexus of veins that communicate with the great venous plexus of the head and the plexus of the paranasal sinuses. If a metastatic hypernephroma to the sinonasal tract is the only clinical metastasis, as in our patient, a radical excision of the solitary metastasis, together with a nephrectomy, is recommended. Physicians dealing with head and neck lesions should always suspect a metastatic tumor and especially, a hypernephroma.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Metaxa's Memorial Cancer Institute, Piraeus, Greece.
authors.forename: N D
authors.initials: ND
authors.lastname: Sgouras
authors.forename: I E
authors.initials: IE
authors.lastname: Gamatsi
authors.forename: E A
authors.initials: EA
authors.lastname: Porfyris
authors.forename: J A
authors.initials: JA
authors.lastname: Lekka
authors.forename: G C
authors.initials: GC
authors.lastname: Harkiolakis
authors.forename: S M
authors.initials: SM
authors.lastname: Nikolopoulou
authors.forename: P J
authors.initials: PJ
authors.lastname: Valvis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000556:secondary*; D005625:Frontal Lobe / Q000000981:diagnostic imaging; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D009669:Nose Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D010255:Paranasal Sinus Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D014057:Tomography, X-Ray Computed