A 79-year-old Japanese woman presented with a rare case of metastatic
renal cell carcinoma to the left sphenoid sinus with left
nasal bleeding. She had previously had right radical
nephrectomy for
renal cell carcinoma at the age of 64 years and brain and spinal cord
infarction at 74 years. Endoscopic examination revealed no mass in the nasal cavity. CT and MRI revealed a
tumor in the left sphenoid sinus. The size of the
tumor increased gradually from 12 to 15 years after the radical
nephrectomy. Complete resection with endoscopic surgery was performed without preoperative embolization. The
tumor cells had clear cytoplasm and were arranged in a trabecular pattern lined by a layer of endothelial cells. These findings were identical to the pathological findings of the surgical specimen of the
renal cell carcinoma from 15 years previous. A pathological diagnosis of metastatic
renal cell carcinoma of clear cell type (grade 1) was made. PET-CT demonstrated no
metastasis. The patient's condition was successfully managed with excision of the
tumor, and she remains well with no evidence of recurrence and
metastasis 36 months
after treatment. Metastatic
renal cell carcinoma to the sphenoid sinus is rare, but it might be considered in the differential diagnosis of masses in the paranasal sinus even long after initial treatment of
renal cancer.