title: Paradoxical spread of renal cell carcinoma to the head and neck.
abstract: OBJECTIVE
  To present cases of renal cell carcinoma presenting with only head and neck metastases, to review theories of physiology and anatomy describing this phenomenon, and to discuss the role of the otolaryngologist in the treatment of these lesions.
  
  
  METHODS
  Retrospective review of the records of three patients who presented with renal cell carcinoma with head and neck metastases over the 3-year period from 1992 to 1995.
  
  
  METHODS
  Retrospective review of the records of three patients who presented with renal cell carcinoma with head and neck metastases. In addition, English-language literature was reviewed with special focus on the anatomic and physiologic pathways possible to allow for such a phenomenon.
  
  
  CONCLUSIONS
  Renal cell carcinoma has an occasional presentation as a head and neck mass without evidence of disease elsewhere. Various routes of spread have been postulated. Batson's venous plexus, as postulated by Nahum and Bailey, is an anatomic route through which emboli could navigate to the head and neck and avoid pulmonary vascular filtration. Interactions on the cellular level may also be responsible for the seemingly paradoxical spread. We recommend local excision of head and neck metastases of renal cell carcinoma without sacrifice of vital structures as a sound treatment regimen.
authors.affiliation: Department of Otolaryngology, New York University School of Medicine, New York 10016, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Gottlieb
authors.forename: J T
authors.initials: JT
authors.lastname: Roland
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery; D005005:Ethmoid Sinus / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010255:Paranasal Sinus Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D014057:Tomography, X-Ray Computed