[Unusual metastasis of hypernephroma in the maxillary sinus].
BACKGROUND
Metastases of infraclavicular malignancies to the nose and paranasal sinuses are characterized by their untypical symptoms and late clinical manifestation. Metastases of renal carcinoma on paranasal cavities may be highly vasculared and can cause profuse bleeding.


METHODS
We report a rare case of a 60-year-old man who suffered from a large metastatic hypernephroma to the right maxillary sinus. Intermittent epistaxis and pain were the first symptoms. The patient had undergone a tumor nephrectomy six months previously. The endonasal biopsy of the vascular tumor caused abundant bleeding which required surgical treatment.


RESULTS
The solitary metastasis was resected by a maxillectomy with closure of the large cavity with a microvascular latissimus dorsi flap. Additionally, a conservative treatment of interleukin-2 and alpha-interferon was administered.


CONCLUSIONS
In case of a solitary metastasis of a renal carcinoma, a radical resection should be considered to improve the prognosis. The possibility of extensive perfusion should be taken into account when taking a biopsy of the lesion in order to be prepared for managing bleeding.
Stieve
M
M
HNO-Klinik der Medizinischen Hochschule Hannover.
Issing
P R
PR
D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage; D007376:Interleukin-2 / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery; D008444:Maxillary Sinus Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D013524:Surgical Flaps / Q000379:methods; D014057:Tomography, X-Ray Computed
D016898:Interferon-alpha; D007376:Interleukin-2