title: Late recurrence from a renal cell carcinoma: solitary right maxilar mass 17 years after surgery.
abstract: OBJECTIVE
  To report a new case of late renal cell carcinoma recurrence.
  
  
  METHODS
  Renal cell carcinoma represents approximately 3% of all adult malignancies. The most frequent metastatic sites are lung (76%), regional lymph nodes (66%), bone (42%), and liver (41%), and it is the third most common infraclavicular neoplasm to metastasize to head and neck.
  
  
  RESULTS
  73 year-old man with a 1 week history of recurrent epistaxis. He underwent left nephrectomy 17 years before due to a renal mass of 8.5 cm in the upper pole of the left kidney. The histological diagnosis of the referred mass was clear cell carcinoma. No metastatic lesion was found at that time (Stage I, pT2N0M0). CT scan showed a mass in the right nasal cavity, invading the right ethmoidal sinus and the right orbit. Examination under general anaesthesia and biopsy was performed revealing metastasis of a renal cell carcinoma.
  
  
  CONCLUSIONS
  The natural history of renal cell carcinoma is highly variable, metastases may present decades after the removal of the primary disease, however, only 1% of patients with renal cell carcinoma have metastases confined only to the head and neck, and solitary cervical metastatic mass is rare. Moreover, renal cell carcinoma should be considered in the differential diagnosis of any growing lesion in the head and neck.
authors.affiliation: Urology Department, Hospital Universitario Central de Asturias, Spain. malvarez79@mixmail.com
authors.forename: Miguel
authors.initials: M
authors.lastname: Alvarez-Múgica
authors.forename: Verónica
authors.initials: V
authors.lastname: Bulnes Vázquez
authors.forename: Antonio
authors.initials: A
authors.lastname: Jalón Monzón
authors.forename: Alberto
authors.initials: A
authors.lastname: Gil
authors.forename: Laura
authors.initials: L
authors.lastname: Rodríguez Robles
authors.forename: Oscar
authors.initials: O
authors.lastname: Miranda Aranzubía
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008441:Maxillary Neoplasms / Q000175:diagnosis*; D016609:Neoplasms, Second Primary / Q000175:diagnosis*; D013997:Time Factors