Case Study: Paranasal Sinus Tumor in a Patient With Kidney Cancer

Patients presenting with nasal or paranasal sinuses tumors should be checked for metastatic kidney cancer, according to a case study presented at the 2022 International Kidney Cancer Symposium: North America.

In this case, a 74-year-old woman presented with a 3-week history of nosebleeds. Her medical history included diabetes, hypertension, and atrial fibrillation. After the nosebleeds had stopped and her blood workup returned unremarkable, she was discharged with a follow-up appointment with otolaryngology. Subsequently, a computed tomography scan showed complete opacification of the right frontal, ethmoid, and maxillary sinuses. The researchers, led by Justin Mehr, noted that the results of magnetic resonance imaging showed a growing mass in the right maxillary sinus, which extended into the nasoethmoidal cavity. Following right nasal endoscopy, maxillary antrostomy, and removal of the mass, a histological exam of cells revealed metastatic clear cell renal cell carcinoma (ccRCC). The patient then underwent immunotherapy, initially nivolumab/ipilimumab followed by nivolumab/cabozantinib. The latter treatment combination successfully shrunk the metastatic renal lesions and the primary site renal mass. The patient then underwent nephrectomy 1 year after the discovery of the maxillary sinus mass. However, 2 months later, the paranasal sinus mass continued, and a histological exam revealed ccRCC.

“Albeit uncommon, metastatic renal cell carcinoma should be a differential diagnosis in patients presenting with nasal and paranasal sinus masses,” the researchers concluded.

Source: Mehr J, Blum K, Maithel N, Citardi M, Canfield S. A case of metastatic renal cell carcinoma to the maxillary sinus initially presenting as recurrent epistaxis. Poster 48. Presented at the 2022 IKCS: North America; November 4-5, 2022; Austin, Texas.